Podcasts about Virginia Commonwealth University

In this Share You Light episode, we welcome Nicole Harp! Nicole is an author, award-winning abstract artist, professional interspecies animal communicator, and graduate of Virginia Commonwealth University with a degree in design.  Her work explores the intersection of art, energy, consciousness, and the profound connection between humans, animals, and the natural world. Through her soul paintings, Nicole intuitively translates the essence and energy of people, animals and spirit into visual form, creating artwork that invites deeper reflection and connection. Nicole has felt a lifelong calling to understand and advocate for animals. As a professional animal communicator, she connects with animals of many species, both living and in spirit, sharing their perspectives, emotions, wisdom, and messages to help people see animals as sentient beings with their own thoughts, feelings and sovereignty. Her work is rooted in the belief that by deepening our understanding of animals, we ultimately deepen our understanding of ourselves and our relationship with the natural world. She is the author of colors of Consciousness; Twenty-Five Soul Paintings, Volume 1 and the creator the Animal Truth Oracle, a 54-card deck written from the animals’ perspective. Nicole also teaches soul painting and animal communication, helping others move beyond the analytical mind and into intuitive, heart-centered connection.  Please contact Nicole at her website Harpspace.org or Nicole@harpspace.org For information about the upcoming Kickstarter for the Animal Truth Oracle Deck   And please follow her at Instagram@harpspace, on Facebook @Harpspace as well as on Substack

Matthew Toffolo chats with Sucheta Sunku Gupta about her experimental short film "Tiger," which was played at the Experimental Dance Music Festival. Sucheta described the film as exploring the experience of growing up with "tiger parents," a strict and high-achievement parenting style common in immigrant communities. She discussed the film's themes of balancing discipline with love and the personal connection many viewers from the Indian community felt with the story. Sucheta explained the film's creation as her Capstone Thesis Project at Virginia Commonwealth University, detailing the process of writing the poetic script, using her sister as the actor, and filming in familiar childhood locations. The discussion also touched on the pressures faced by children of immigrant parents, the challenges of competitive sports, and Sucheta's future plans in filmmaking and art direction. —- Subscribe to the podcast: https://twitter.com/wildsoundpod https://www.instagram.com/wildsoundpod https://www.facebook.com/wildsoundpod —— Love for you to try the Indy Film Festival AP. • Daily new film festival of the best new films from around the world. New archived festival to watch anytime. • Library of over 500+ award-winning films to watch anytime. Go to https://www.wildsound.ca and sign up for the free 3-day trial. Check out the daily film festival (and previous ones from last month) at https://www.wildsound.ca/browse Always an amazing lineup of films. Inspiring for storytellers.

Kevin Stoller sits down with Dr. George Hummer, Superintendent of Frederick County Public Schools, to explore his journey from special education aide to school district leader, and the district's ongoing effort to build its fourth high school. Dr. Hummer shares how his mother's career as a special education teacher and his own experience working with students with disabilities shaped his empathy-driven leadership style. The conversation dives deep into the mechanics of planning new school construction — including the critical difference between "design capacity" and "program capacity," how Frederick County builds community trust through transparent data, and why involving every stakeholder voice (parents, teachers, students, county officials) is essential to a successful bond and building process. Dr. Hummer also reflects on team-building, situational leadership drawn from his coaching background, and why investing in students must remain the non-negotiable priority behind every facilities decision. Takeaways: Program capacity vs. design capacity — A room's legal occupancy limit isn't the same as how many students it can actually serve well; specialized programs (special ed, ELL, CTE, kindergarten) mean real capacity is often much lower than code allows. Run schools at 85–90% capacity, not 100% — Like redlining a car engine, operating school buildings at full capacity year-round accelerates wear and leaves no room for enrollment shifts or new programs. There's no such thing as too many voices — Successful school construction requires input from county officials, principals, teachers, parents, and even students — genuine inclusion builds long-term community trust. Seek out your critics, not just your supporters — Dr. Hummer's willingness to sit down with a skeptical taxpayer and address misinformation directly turned an opponent into an advocate for the new high school. Situational leadership matters — Knowing when to encourage versus when to push for improvement (borrowed from his coaching background) is key to building strong, resilient teams.   About Dr. George Hummer: Dr. George C. Hummer began serving as Frederick County's Superintendent of Schools on January 30, 2023. He is a native of New Jersey who moved to Virginia in 1994. He graduated from Chancellor High School in Fredericksburg and received a bachelor of arts degree from Radford University in 2005. Dr. Hummer also holds a master's degree in educational leadership and special education from the University of Mary Washington as well as a doctorate in educational leadership from Virginia Commonwealth University. Dr. Hummer credits his mother, who was a lifelong special education teacher, with inspiring him to pursue a career in education. He began his career as a special education teacher, athletic director, and football and basketball coach at Battlefield Middle School in Fredericksburg. After serving in those roles from 2005 to 2012, Dr. Hummer was named assistant principal at Rodney Thompson Middle School in Stafford and served in that capacity for three years. In 2015, Dr. Hummer was named the Supervisor of Student Services and Special Education for Stafford County Public Schools. Four years later, he became Stafford County Public Schools' Executive Director of Student Services and Special Education. In 2022, he was named that school division's Chief Student Support Services Officer. As a teacher, Dr. Hummer was recognized with a Teacher of the Year Award and for improving the performance of his students. As a central office administrator, Dr. Hummer has spent countless hours supporting students, families and staff while working to develop better procedures to help bridge the achievement gap for all students. In 2021, the Virginia Council of Administrators of Special Education recognized Dr. Hummer with the Mary Lou Wall Award for Early Special Education Leadership. The award recognizes individuals who are in their first three years of leading a school division's special education services and exemplify five values: (1) Heart- the passion to serve, nurture and care; (2) Leadership by example; (3) Honesty; (4) Creative thinking; and (5) Collaboration. From 2018 to 2023, Dr. Hummer served as an adjunct professor of educational leadership and education at the University of Mary Washington. He has also been a featured speaker at several state meetings for the Virginia Department of Education. Dr. Hummer is proud to remain actively engaged in the Frederick County and Northern Shenandoah Valley communities. He currently serves on the boards of the Valley Health Foundation, United Way of Northern Shenandoah Valley, Grafton School Foundation, and Frederick County Education Foundation. He is also an active member of the Rotary Club of Frederick County. Through these meaningful partnerships, Dr. Hummer enthusiastically supportsefforts that strengthen our students, education, health, opportunity, and overall community well-being throughout the region. Dr. Hummer, his wife, Charnell, and his step-daughter, Madison, live in Frederick County.   Episode 354 of the Better Learning Podcast For more information on our partners: Association for Learning Environments (A4LE) - https://www.a4le.org/ Education Leaders' Organization - https://www.ed-leaders.org/ Second Class Foundation - https://secondclassfoundation.org/ EDmarket - https://www.edmarket.org/ Catapult @ Penn GSE - https://catapult.gse.upenn.edu/ Want to be a Guest Speaker? Request on our website

Many school-based occupational therapists are working with students who have cortical visual impairment (CVI) but don't recognize it. Unlike ocular visual impairments, CVI is a brain-based processing issue that affects functional vision in ways that fluctuate with environment, fatigue, and sensory complexity. In this episode, Lauren Andelin, OTD, OTR/L, BCP, assistant professor at Virginia Commonwealth University and assistive technology clinician at Children's Hospital, explains what CVI looks like in school settings and why it matters for OT practice.This episode is for school-based OT practitioners who may be working with students with CVI without fully recognizing the signs, or who want practical strategies to support functional vision in the classroom. Lauren explains the difference between ocular and cortical visual impairments, shares the key behavioral signs to watch for, and offers immediately useful strategies like using preferred colors, managing visual complexity, and understanding visual fatigue.Whether you suspect a student on your caseload might have CVI or you want to better support students with known diagnoses, this episode will give you actionable strategies you can use starting tomorrow.Listen now to learn the following objectives:— Learners will describe why CVI is a brain-based visual processing difference and how environmental factors like clutter, lighting, fatigue, and sensory load can affect functional vision.— Learners will identify common behavioral signs and red flags that may indicate CVI in school settings.— Learners will recognize why CVI is often under-identified and misunderstood in schools.Thanks for tuning in! Thanks for tuning into the OT Schoolhouse Podcast brought to you by the OT Schoolhouse Collaborative Community for school-based OTPs. In OTS Collab, we use community-powered professional development to learn together and implement strategies together. Don't forget to subscribe to the show and check out the show notes for every episode at OTSchoolhouse.comSee you in the next episode! 

For Faithful Politics, this conversation is especially local. Rep. Rob Wittman represents Virginia's 1st Congressional District, the same district where our Josh lives.We ask Wittman, in this shorter interview, what Congress can do about the cost of living, including energy, housing, health care, and grocery prices. We also press him on President Trump's proposed $5,000 payment to Americans and how Congress would pay for it.The conversation then turns to the Republican Party and a question many conservatives are wrestling with: when should a Republican member of Congress be willing to disagree with Donald Trump? Wittman points to his vote to override Trump's veto of the National Defense Authorization Act and his opposition to proposed cuts to Chesapeake Bay funding as examples.We also discuss political division, his bipartisan relationships in Congress, and what he believes Washington can do to rebuild some level of trust across party lines.Finally, with Wittman seeking another term representing VA-01, we ask him directly why voters should choose him over Democratic nominee Shannon Taylor. Wittman discusses his record in Congress and raises several criticisms of Taylor's record as Henrico County Commonwealth's Attorney.LINK MENTIONED IN THE INTERVIEW SoftShannonTaylor.com Guest Bio:Rep. Rob Wittman has represented Virginia's 1st Congressional District since 2007. He serves as vice chairman of the House Armed Services Committee and chairs its Tactical Air and Land Forces Subcommittee, giving him a central role in debates over national defense and military readiness. He also serves on the House Natural Resources Committee, with a particular focus on the Chesapeake Bay and Virginia's coastal communities. Before Congress, Wittman worked in state government and served in local and state elected office. He holds a Ph.D. in Public Policy and Administration from Virginia Commonwealth University.

Hypersomnia encompasses a group of disorders characterized by excessive daytime sleepiness that can significantly impair quality of life and neurologic function. In this episode, Dr. Margaret Kay-Stacey discusses how to recognize and evaluate hypersomnia, reviews key features of narcolepsy and idiopathic hypersomnia, and highlights the many neurologic conditions associated with excessive sleepiness. Learn practical approaches to diagnosis, treatment, and distinguishing primary hypersomnia disorders from more common causes such as insufficient sleep, sleep apnea, medications, and depression. In this episode, Gordon Smith, MD, FAAN, speaks with Margaret Kay-Stacey, MD, author of the article "Hypersomnia" in the Continuum® August 2026 Sleep Neurology issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia.   Dr. Kay-Stacey is an Assistant Professor of Neurology and Ambulatory Medical Director at the University of Chicago Medical Center in Chicago, Illinois. Additional Resources Read the article: Hypersomnia Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @GordonSmithMD  Full episode transcript available here Dr Smith: So, what do myotonic dystrophy, Parkinson's disease, and traumatic brain injury have in common? It turns out that each can cause clinically significant and meaningful hypersomnolence. And did you know that narcolepsy has the same population prevalence in the United States as myasthenia gravis, something I commonly see in clinic? If you want to learn more about hypersomnolence and how it impacts the patients you care for and what to do about it, keep listening.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Smith: This is Dr. Gordon Smith. Today, I'm interviewing Dr. Meg Kay-Stacey about her article on hypersomnia, which appears in the August 2026 Continuum issue on the neurology of sleep. Meg, welcome to the podcast, and maybe you can begin by just introducing yourself to our audience.  Dr Kay-Stacey: Yeah. Hi, I'm so glad to be here. So, like you said, I'm Meg Kay-Stacey. I'm a sleep neurologist at the University of Chicago. I'm also the AAN's Sleep Section vice chair.  Dr Smith: Awesome. I didn't quite know what to expect in reading your article, except it was gonna be about people who are really sleepy. I was really amazed at how common these problems are, even, we'll get into this, disorders that I think of as being super rare. So, I know our listeners are gonna really enjoy hearing from you. I wonder if you could begin by just defining hypersomnia and maybe give us a flavor for the impact this has on patients who have primary disorders of hypersomnia.  Dr Kay-Stacey: Yeah. I mean, so hypersomnia is really an excessive daytime sleepiness, so a feeling of excessive sleepiness, feeling like they can't stay awake during the day. And these patients' quality of life is quite impacted by these symptoms, and there's lots of different conditions that can cause it, but it can be quite detrimental to day-to-day living.  Dr Smith: I honestly am sleepy a lot cause I work too hard or stay up late, and sleepiness seems to be a very common symptom. How do you sort out when a patient's excessive daytime sleepiness is pathologic related to lifestyle and the extent to which it may be a sleep apnea versus one of the other disorders that we'll talk about?  Dr Kay-Stacey: Yeah. I mean, you really have to take a good history. So as neurologists, we know that, that we have to do that, but particularly a sleep history and really understand, first and foremost, how much sleep the patient is getting. Really important to understand, are they getting adequate sleep at night, right? Because chronic insufficient sleep can cause daytime sleepiness, right? And can make people appear like they might have a primary hypersomnia disorder when in fact they don't. So that's sort of first and foremost, and then it's assessing the other symptoms that they have. So, it's assessing nocturnal symptoms. You mentioned sleep apnea, so assessing for things like snoring and witnessed apneas, nocturia, and then assessing for what the quality of their sleep like. Is it refreshing? Is it not refreshing? How easy or hard is it to wake up in the morning? And then asking them again about daytime symptoms. Are you falling asleep inappropriately at work? Are, you know, you falling asleep while driving? Are you finding it hard to stay awake even after you've had a full night of sleep? To really try to differentiate what the symptoms might be from. And then it's also assessing things, sleep apnea, for example, physical exam findings. You know, are they obese? Do they have a larger neck circumference? Is the airway more crowded? And then we do have some measures, some scales, so there's the Epworth Sleepiness Scale that we'll use that assesses sleepiness, which is kind of a good way to at least initially assess how sleepy a patient might be during the day.  Dr Smith: So that's great, and we'll talk a bit about sleep apnea, I hope. But when I hear hypersomnia, I always think about narcolepsy, and I wonder if maybe we can begin there.  Dr Kay-Stacey: Yeah.  Dr Smith: I was super interested to learn how common this is. About as common as myasthenia gravis. Actually, the population prevalence number is exactly the same as myasthenia. My Monday morning clinic is mostly myasthenia. So how do we recognize narcolepsy? Cause I'm worrying that I'm missing it.  Dr Kay-Stacey: Yeah. So, narcolepsy, you know, there's two types. There's narcolepsy type 1 and narcolepsy type 2. So, narcolepsy type 1 is a little easier because you have cataplexy. But with both conditions, you're gonna see excessive daytime sleepiness. You're gonna ask about things like sleep paralysis, whether or not they're having sleep-related hallucinations, so hypnagogic or hypnopompic hallucinations. Are they having other sort of REM, intrusion phenomenon? You may also hear things like REM behavior disorder, so acting out their dreams at night, and then some degree of, you know, difficulty waking up in the morning, feeling like they need to nap. Naps are often more refreshing in patients with narcolepsy which is a feature that when we talk about idiopathic hypersomnia kind of helps to differentiate them. So, it's really just asking about sleepiness and assessing for these other symptoms that they can have associated with narcolepsy.  Dr Smith: I was also interested to learn that narcolepsy is the most common cause of REM sleep behavior disorder in young patients, which is pretty cool. But I wonder, you used a term that I've never heard of, and I'm betting some of our listeners haven't, which is REM intrusion phenomenon. Could you tell us more about that? Dr Kay-Stacey: Yeah. So, this is the idea that in narcolepsy, your sleep states are sort of, jumbled up, would be the way of thinking of it. You have these phenomenon where REM will persist into wakefulness. So, sleep paralysis is actually a perfect example of that, right? That you wake up and you feel like you're awake, but your body is still paralyzed, you can't move. Cataplexy is similarly a REM intrusion phenomenon, as are these hallucinations that I mentioned, the sleep-related hallucinations.  Dr Smith: So what pearls do you have for recognizing cataplexy? What's the spectrum of cataplexy?  Dr Kay-Stacey: Yeah. So, I think cataplexy, it's associated with emotion, right? And we most commonly think about it being associated with laughter, right, with positive emotion, but it's key to remember that it can happen with negative emotion too, with fright, being upset or angry. And usually when you're asking patients about it, you wanna phrase it to understand, are they having episodes where they feel like they have brief loss of muscle tone? And it can be subtle. It can be a head drop, their mouth opening, a hand dropping something, and it's brief. Usually it's seconds to just a couple of minutes. These aren't prolonged episodes, and they're not losing consciousness. They're awake, they're just having that brief loss of muscle tone.  Dr Smith: So, what about orexin? I'm particularly interested in how often it's necessary to do an LP and look for CSF orexin levels. Is that a common thing in your practice, or do you rely on clinical phenomenology in a, you know, polysomnogram with multiple sleep latency testing to confirm a diagnosis of narcolepsy?  Dr Kay-Stacey: Most commonly, you're gonna still do the PSG and the MSLT, obviously, because it's less invasive than doing the lumbar puncture. There are scenarios, right, where you may consider doing the LP. I think if someone has cataplexy and you're pretty confident in that and they have a positive PSG, MSLT testing done, you know, you really don't need the lumbar puncture, right? But if you're in that gray area that for whatever reason you have a really high suspicion they have narcolepsy, but for whatever reason the PSG, MSLT either couldn't be done or it was inconclusive, then I might think about doing the lumbar puncture. The other scenario is that there are some patients who have to be on REM-suppressing medications, like antidepressants, for example. In those patients, it can confound the results. And so, if you're not able to stop those for the MSLT testing, then that would be a scenario where I might use the lumbar puncture. Insurance is another reason that, again, if you have some of that inconclusive findings on the PSG, MSLT, that doing the lumbar puncture then can help to confirm the diagnosis, but only useful for type 1 narcolepsy, not type 2.  Dr Smith: And type 2 is like type 1 but without cataplexy?  Dr Kay-Stacey: Exactly. And then you kind of can think of it as sort of on a spectrum, I would say. There's sort of narcolepsy type 1, and there's idiopathic hypersomnia, and narcolepsy type 2 kind of falls in between.  Dr Smith: Do you require the other core features of narcolepsy to make a diagnosis of type 2, like sleep paralysis, hallucinations?  Dr Kay-Stacey: Right. You do. You don't necessarily have to have all of them, but you will see similar features, though most of them are more common in, in type 1 than in type 2.  Dr Smith: So, I'm understanding you need to see, REM intrusion phenomena.  Dr Kay-Stacey: Mm-hmm. Yes.  Dr Smith: I love saying that. Makes me sound like I'm part of the sleep team. Now we're all part of the sleep team, aren't we?  Dr Kay-Stacey: Yeah.  Dr Smith: What about idiopathic hypersomnia? In reading about it and thinking about it, it sounds a lot like narcolepsy without those other features, but there, there are some differences. I wonder if you could give our listeners pearls into how to recognize that as opposed to maybe type 2 narcolepsy.  Dr Kay-Stacey: Yeah. So idiopathic hypersomnia patients are also very sleepy during the day. They're more commonly going to describe that they sleep through the night, often for long hours, and that they wake up and still feel very unrefreshed. They'll have what we call, morning sleep inertia, or some people call it, you know, sleep drunkenness, where when they wake up in the morning, they feel like they're in a haze or a fog. It's really hard to get out of bed. They're often setting multiple alarms. And this is after having a full night of sleep, ten, twelve hours of sleep, and then they just feel tired and sleepy all day. If they nap, their naps will often feel unrefreshing, and when they take naps, they're often longer naps, and then they wake up and again will maybe feel some of that sleep drunkenness or inertia, and it makes it difficult for them to wake up. And then they don't have as many of the REM intrusion phenomena, but you still can sometimes hear things like sleep paralysis or the hallucinations in patients with idiopathic hypersomnia. And so that's where it does get tricky when you're trying to differentiate from narcolepsy. Really, the difference with narcolepsy and idiopathic hypersomnia when you do testing has to do with what you see on the overnight sleep study on the polysomnogram followed by that multiple sleep latency test. In the case of all three conditions, the MSLT should show a mean sleep latency of eight minutes or less. What separates narcolepsy from idiopathic hypersomnia is that in narcolepsy, the expectation's you'll have two or more sleep onset REM periods, so you go into REM sleep very quickly. Whereas in idiopathic hypersomnia, you'll have one sleep onset REM period or less. Traditionally, you'd think of that you wouldn't have any, but you theoretically could have one on that. So, that's sort of one way that we can differentiate the two.  Dr Smith: That's really helpful, actually. Thank you. What about treatment? There are a whole bunch of different medications that you talk about in your article, including, medications that are in the pipeline, which is exciting. What's the treatment approach, maybe starting with narcolepsy?  Dr Kay-Stacey: Yeah. So, with narcolepsy, there are more FDA-approved medications and options then there are for idiopathic hypersomnia, which is, you know, one of the things I hope will change over time with things that are in the pipeline. But with narcolepsy, traditionally often start first with an alerting agent such as modafinil or armodafinil to really help with those daytime symptoms. And then there are a number of other medications that can be used. Sometimes if the armodafinil, modafinil don't work, we'll advance into stimulant medications that are amphetamine containing. At night, there's a medication called sodium oxybate that you can take for narcolepsy. The low sodium oxybate is actually also approved for idiopathic hypersomnia. But sodium oxybate, the idea is that you're taking it at night, and it's helping to reduce the disrupted sleep that occurs in patients with narcolepsy, really kind of enhances slow-wave sleep at night and makes the sleep that patients are getting better quality, which then improves both excessive daytime sleepiness during the day as well as the cataplexy. And then there are some other medications, solrimfetol and pitolisant, that are also used in narcolepsy. I don't wanna necessarily get into the nitty-gritty of all of the mechanisms of action, but definitely read the article to learn more about that. Dr Smith: So that's really helpful. What about cataplexy? Do these medicines also help with cataplexy, or is there a different approach for that symptom?  Dr Kay-Stacey: Yeah. So, sodium oxybate definitely can be used, and the low-dose sodium oxybate can be used to help with the cataplexy. But then we'll also sometimes use medications in the antidepressant category as well. So, SSRIs, SNRIs, and tricyclic antidepressants can all also be used to help in the treatment of cataplexy.  Dr Smith: And how about idiopathic hypersomnia?  Dr Kay-Stacey: Yeah. So, for idiopathic hypersomnia, there are, you know, as I mentioned, less treatment options and not as many things FDA-approved. But, it was exciting, low-dose sodium oxybate was approved for idiopathic hypersomnia, so it's taken at night, similar to how it's used in narcolepsy, and does improve that excessive daytime sleepiness. And then we often will also use some of the other medications off-label, so modafinil, armodafinil, and the stimulant medications. But some of the other meds like the pitolisant and solrimfetol, those are not FDA-approved for the use in idiopathic hypersomnia.  Dr Smith: So, I'm curious if we know what causes these conditions, so narcolepsy type 1, type 2, and idiopathic hypersomnia. I mean, the treatments all seem very kind of neuromodulatory in some way, you know, interacting with the REM system, for instance. What's the current thought regarding mechanism, underlying cause?  Dr Kay-Stacey: So, narcolepsy type 1, it's due to the loss of orexin neurons in the hypothalamus. So that one is sort of the easiest of them that we know that those orexin-producing neurons are lost. There are thoughts that both with narcolepsy 1 and type 2, that there is autoimmune related concept and then also potentially some genetics, though it's not completely clear that it's one mechanism or another. But certainly, easiest is narcolepsy type 1 with that loss of orexin neurons. For idiopathic hypersomnia, we're not exactly sure actually what causes it. Again, some thoughts about maybe there being an autoimmune-related phenomenon for some patients, may begin for them after they've had infection, for example. And then some thoughts that perhaps GABA receptors are impacted in idiopathic hypersomnia.  Dr Smith: Great. Well, that's super helpful, and I'm definitely gonna be on the lookout for narcolepsy. But let me pivot. I wonder if we might play a little bit of a game here. There's so many other things that cause hypersomnia, other disorders and situations, and rather than kind of march through them, I wonder if I could give you a name of a particular neurologic disease or situation and have you provide our listeners just a sentence or two about one thing they should know about hypersomnia in that disorder. You up for it?  Dr Kay-Stacey: Sure.  Dr Smith: So, let's begin with my backyard, myotonic dystrophy.  Dr Kay-Stacey: Yeah. So myotonic dystrophy, we see an association actually with narcolepsy. So, certainly with patients with myotonic dystrophy, you'll see excessive daytime sleepiness, and should be screening them for narcolepsy. You should also be screening them for sleep apnea.  Dr Smith: How about Parkinson's disease?  Dr Kay-Stacey: Parkinson's disease, at least a third of those patients will describe excessive daytime sleepiness. They can also experience sleep attacks during the day, likely has to do with dopaminergic mechanisms.  Dr Smith: So, I'm gonna ask a question in the middle of our game. So, in myotonic dystrophy, it's actually true narcolepsy. So, you would want to screen for that, and then if they meet the criteria, you would treat them similar to we spoke about earlier. All right. How about traumatic brain injury?  Dr Kay-Stacey: Yeah. So traumatic brain injury, very common for patients to experience excessive daytime sleepiness. Those patients will also experience circadian dysregulation. So, when you're interacting, you know, with those patients, you definitely wanna get a good sleep history, understand is there a circadian component, or is it true excessive hypersomnia related to the brain injury?  Dr Smith: How about multiple sclerosis?  Dr Kay-Stacey: So, MS, not as common for it to be hypersomnia per se, more common to hear fatigue in these patients. I do think, again, sleep apnea is probably under-recognized in MS patients, so making sure you're screening for that. But not-- do not classically hear, you know, primary hypersomnia disorders, more so fatigue. But MS fatigue is treated similarly to some of our hypersomnia conditions, often use a modafinil or an armodafinil for that.  Dr Smith: How about medications? Dr Kay-Stacey: So, there's a lot of medications that can cause excessive daytime sleepiness, a lot of medications that we as neurologists give, right? We're very aware that our anti-seizure medications can potentially cause excessive daytime sleepiness. The antidepressants that we use to treat various neuropathic pain conditions and migraines can cause sleepiness. The antidopaminergic medications can cause sleepiness. Benzodiazepines can cause sleepiness. Muscle relaxers can cause sleepiness. So, lots of different, medications that we use to treat neurologic conditions can create sleepiness.  Dr Smith: How about stroke?  Dr Kay-Stacey: Stroke can cause sleepiness too. Also can cause fatigue, and sometimes it can be challenging to differentiate. There's also a higher incidence of sleep apnea in patients with stroke as well, so you definitely wanna make sure that you're screening for that. But yeah, depending on the location of the stroke too, that can also contribute to the sleepiness 'cause if it's anywhere sort of along the ascending reticular activating system, it could cause a problem. Dr Smith: And maybe one more, depression.  Dr Kay-Stacey: Yeah, so depression also can be tricky to differentiate from hypersomnia, and you do really wanna make sure when you're seeing these patients that you're assessing to make sure that it's not the depression that's causing them to be sleepy. You know, patients with depression will often spend long hours in bed and spend a lot of time sleeping, and so you do really kind of have to piece that together and figure out what's what.  Dr Smith: Hey, that was fun, and I think we've probably convinced everyone who's listening to us that they probably should check out and read the article because guaranteed, no matter what you do in neurology, there's something in this article for you. One thing we didn't talk about, one of the kind of eight central causes of hypersomnolence that I thought worth kind of winding up with is insufficient sleep syndrome. I wonder if we might talk about this from the point of view of our listeners. And what advice do you have to neurologists and people who care for patients with brain disease regarding self-care and sleep self-care and not ending up with insufficient sleep syndrome?  Dr Kay-Stacey: Yeah. Great question, and I think I have been thinking a lot about just sleep in general because sleep is so important to brain health, right? I know the AAN has been big proponents of the importance of sleep, and there was lots of talk about it at the annual meeting because of that. You know, the average adult needs somewhere between seven and nine hours of sleep per night. So, if you're getting less than that, you are at risk for insufficient sleep, and that insufficient sleep builds up over time. So, you can't recover from many months or years of insufficient sleep by sleeping for just one night. And so, it is really important to make sleep a priority because when you have chronic insufficient sleep, it can mimic some of these other conditions. You can see narcolepsy-like symptoms where you're falling asleep inappropriately, where it's impacting your quality of life, potentially impacting your ability to drive. So definitely very important to really try to target that seven to nine hours of sleep per night. And I think from a self-care standpoint, if you feel like you are getting that seven to nine hours of sleep per night and you're still feeling sleepy or still feeling unrefreshed or dozing off during the day, then you really should get assessed for an underlying sleep condition that might be causing you to feel that way.  Dr Smith: So, Meg, this has really been such a great conversation, and it's a really great article. I wonder if we might wind up with one more question, which is if there was one thing our listeners should remember from our conversation, other than to kind of wait for their Continuum issue to arrive and immediately read this article, what would it be? What should they remember?  Dr Kay-Stacey: I think that if a patient is telling you that they're sleepy or tired during the day, that you really need to dig in and figure out what it is. Is it something that they themselves are doing that's behaviorally induced? Is it something that's happening with their sleep at night? Or is it an underlying primary hypersomnia condition that you can treat, right? These conditions are treatable, and you can have really a significant impact on quality of life, which is, you know, the best part of our jobs when we can actually make our patients feel better.  Dr Smith: Fantastic. Meg, thank you so much. I know that our listeners really enjoyed this. I know they'll enjoy the article as well. Thank you. Again, today, I've been interviewing Dr. Meg Kay-Stacey about her article on hypersomnia, which appears in the August 2026 Continuum issue on the neurology of sleep. Be sure to check out Continuum Audio episodes from this and other issues, and thanks to you, our listeners, for joining us today.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audiocme. Thank you for listening to Continuum Audio. 

With back-to-school season in full swing, we've got two Fellows and public administration education experts on the podcast: David Van Slyke, dean of The Maxwell School of Citizenship and Public Affairs at Syracuse University, and Susan Gooden, professor and former dean of the L. Douglas Wilder School of Government and Public Affairs at Virginia Commonwealth University. Both join host James-Christian Blockwood for a very educational discussion.They share challenges and triumphs in public administration education, and what may be next for schools around the country.Management Matters is a presentation of the National Academy of Public Administration produced by and edited by Matt Hampton. Support the Podcast Today at: donate@napawash.org or 202-347-3190Episode music: Hope by Mixaund | https://mixaund.bandcamp.comMusic promoted by https://www.free-stock-music.comFollow us on YouTube for clips and more: @NAPAWASH_YT

Watch the show on television by downloading the SuperCrowd.tv Channel app to your Roku or Amazon Fire TV or e360tv channel app to your Roku, LG or Amazon Fire TV. You can also see it on YouTube.Devin: What is your superpower?Jason: I like to think that we are people with big brains and small egos. If we are high-impact, low-ego folks and we keep our eye on the ball, that's a recipe for success no matter what industry you're in.NextGen Scientific is turning an ancient Middle Eastern medicinal plant into a modern platform for cancer drug development and wellness products.In this episode, I spoke with Jason West, co-founder of NextGen Scientific, a PurposeBuilt100™ company recognized for combining growth with measurable impact. Jason explained that the company operates along two related tracks: Hyatt Life Sciences, its dietary supplement business and Genzada Pharmaceuticals, its drug discovery and development company.The common thread is chemistry.Jason described the company's work with Arum palestinum, a plant that grows wild in the Middle East and has long been used there as a tea. That history is what pulled the scientific team in.“What caught our attention was that there are references to the use of this plant as a medicinal plant going all the way back to the 9th century AD,” Jason said. “For 1,100 years, it's been in continuous use.”That kind of longevity raised a serious scientific question for the team: why would people keep using it for more than a millennium if there were no benefit? Jason said NextGen began studying naturally occurring molecules in the plant, ultimately identifying compounds that became the basis for its oncology research.The company now has two lead oncology or oncology-related drug candidates. One is an oral capsule in clinical trials at Virginia Commonwealth University for late-stage prostate cancer, with trials expected in the Netherlands and Sweden. The other is a topical cream aimed at actinic keratosis, a precancerous skin condition with tens of millions of cases annually in the United States.Jason emphasized that the goal is not to replace oncologists but to help them. “We feel like we can be just one more tool in the toolbox of the oncologist, and that's what our ultimate goal is,” he said.Congratulations to NextGen Scientific LLC on ranking #46 on the 2026 PurposeBuilt100™ list! We're proud to recognize the company among America's fastest-growing mission-driven businesses, celebrating the connection between purpose, innovation, and growth. Meet the Class of 2026 — see the full list of winners →What I found especially compelling is the company's dual-path strategy. Drug development can be slow, expensive and risky. By building a supplement business alongside the pharmaceutical pipeline, NextGen has created revenue while continuing the long FDA-focused journey.That strategy emerged organically. In rural Kansas, word spread that the family was working with a tea tied to cancer wellness. People began asking for it. “By the end of the day, I think we were sending about 40 gallons of this tea out a week just to friends and family,” Jason said.NextGen Scientific is currently raising capital through a Regulation D offering for accredited investors, targeting just over $10 million. Jason said proceeds will help accelerate clinical trials, open new trial fronts and support marketing for the supplement business.It is exactly the kind of purpose-built growth story I love to celebrate.tl;dr:Jason West's team is translating an ancient Middle Eastern plant into cancer drugs and supplements.NextGen Scientific pairs Genzada Pharmaceuticals' clinical pipeline with Hyatt Life Sciences' wellness products.Small-town curiosity created unexpected demand, eventually reaching roughly 40 gallons of tea weekly.A Regulation D raise seeks just over $10 million from accredited investors to accelerate trials.Low-ego brilliance helps Jason keep hard conversations focused on data, kindness and learning.How to Develop Low-Ego Brilliance As a SuperpowerJason's superpower is Low-Ego Brilliance. He describes it as being among people with “big brains and small egos.” For Jason, the combination matters because “if we are high-impact, low-ego folks and we keep our eye on the ball, that's a recipe for success no matter what industry you're in.” He connects the idea to persistence, humility and disciplined focus: “You just have to keep on putting one foot in front of the other.” His advice is simple but powerful: “Take the phone call. Always take the phone call.”Jason shared a story about meeting with an exceptionally smart but highly skeptical person who seemed to have little patience for NextGen's science. Rather than taking offense or trying to win a personality contest, Jason and his team stayed calm and redirected the conversation to the data. A meeting scheduled for 15 or 20 minutes stretched to about two hours. By the end, the skeptic had become a friend. Jason summed up the lesson this way: “If you have the data on your side, you don't need to be too big for your britches.”Build teams with big brains and small egos; value impact over status.Keep your eye on the ball, especially when the work is long and difficult.Put one foot in front of the other rather than demanding instant success.When challenged, redirect the conversation to evidence instead of emotion.Be kind to skeptics; you can catch more flies with honey than vinegar.Take the phone call when you can because there is almost always something to learn.Stay curious, not judgmental, especially when you assume a conversation will not matter.By following Jason's example and advice, you can make low-ego brilliance a skill. With practice and effort, you could make it a superpower that enables you to do more good in the world.Remember, however, that research into success suggests that building on your own superpowers is more important than creating new ones or overcoming weaknesses. You do you!Guest ProfileJason West (he/him):Executive Vice President, NextGen ScientificAbout NextGen Scientific: NextGen Scientific is a biotechnology and life sciences company dedicated to advancing innovative oncology research and developing evidence-based therapeutic solutions. Focused on cancer research, tumor biology, precision therapeutics, and plant-based pharmaceutical and bioactive compounds, the company works to bridge the gap between scientific discovery and real-world healthcare impact. Through translational medicine, preclinical research, intellectual property development, and a disciplined, research-driven approach, NextGen Scientific is building novel, scalable solutions designed to advance the future of cancer care and therapeutic innovation.Operating at the intersection of biotechnology, healthcare innovation, and commercial strategy, NextGen Scientific has developed a dual-entity model that combines biotechnology development with a revenue-generating wellness platform. Alongside its oncology pipeline, the company brings science-backed nutraceutical and metabolic wellness products to market, creating a sustainable engine to support continued research and growth. As NextGen Scientific expands its oncology pipeline, patent portfolio, and commercialization strategy, it remains focused on translating promising science into safe, effective, and impactful health solutions.Website: investinnextgen.comLinkedIn: linkedin.com/company/nextgen-scientificBiographical Information: Jason West is a seasoned executive and entrepreneur with extensive leadership experience across biotechnology, pharmaceuticals, life sciences, chemicals, and business development. He currently serves as Executive Vice President of Genzada Pharmaceuticals and NextGen Scientific, while also serving as Chairman of Geo-Chemicals, LLC and Chief Executive Officer of Hyatt Life Sciences. His career reflects a strong combination of scientific knowledge, legal expertise, and executive leadership, with a focus on building and guiding organizations at the intersection of science, innovation, and commercial growth.Earlier in his career, Jason spent 15 years with Jacam Chemical Company, including more than seven years as President and seven years as Vice President and General Counsel. He holds a Bachelor of Science in Biology from Sterling College, a Juris Doctor from Vermont Law School, and an MBA from Northwestern University's Kellogg School of Management. With experience spanning scientific research, law, corporate leadership, and strategic management, Jason brings a multidisciplinary perspective to advancing innovative businesses and life sciences initiatives.LinkedIn: linkedin.com/in/jason-west-b33b7a163Watch the Impact Stories on BIG Screen!Support Our SponsorsOur generous sponsors make our work possible, serving impact investors, social entrepreneurs, community builders and diverse founders. Today's advertisers include PurposeBuilt100™ Winners and supercrowd.tv. Learn more about advertising with us here.Max-Impact Members(We're grateful for every one of these community champions who make this work possible.)Brian Christie, Brainsy | Cameron Neil, Lend For Good | Carol Fineagan, Independent Consultant | Eric Coury, Arthia AI | Joey Hayes, thru | John Berlet, CORE Tax Deeds, LLC. | Justin Starbird, The Aebli Group | Ken Steele, Rotarian | Lory Moore, Lory Moore Law | Marcia Brinton, High Desert Gear | Mark Grimes, Networked Enterprise Development | Mike Babbit | Coledger Solutions | Mike Green, Envirosult | Nick Degnan, Unlimit Ventures | Paul Lovejoy, Stakeholder Enterprise | Pearl Wright, Global Changemaker | Scott Thorpe, Philanthropist | Sharon Samjitsingh, Health Care Originals | Add Your Name HereUpcoming SuperCrowd Event CalendarIf a location is not noted, the events below are virtual.Join the SuperCrowd Impact League! You can be recognized for making impact investments via Reg CF. See how your activity compares to your peers. It's free. Win valuable prizes. Start now!SuperCrowd Impact Member Networking Session: Impact (and, of course, Max-Impact) Members of the SuperCrowd are invited to a private networking session on September 8th at 8:00 PM ET/5:00 PM PT. Mark your calendar. We'll send private emails to Impact Members with registration details. Upgrade to Impact Membership today!Apply for the Superpowers for Good Live Pitch: Are you raising capital through Regulation Crowdfunding? Apply by September 2 for the September 30 Superpowers for Good Live Pitch. Selected founders pitch free to investors and gain exposure through SuperCrowd.tv, e360tv, social media, and our 10,000-subscriber newsletter. We especially encourage social entrepreneurs, women and underrepresented entrepreneurs to apply.Visit Our Complete Community Event CalendarIf you would like to submit an event for us to share with the 10,000+ changemakers, investors and entrepreneurs who are members of the SuperCrowd, click here.Manage the volume of emails you receive from us by clicking here.We share educational information—not investment advice. Some links may generate compensation. See our full disclosure.We use AI to help us write compelling recaps of each episode. Get full access to Superpowers for Good at www.superpowers4good.com/subscribe

Interview with Steven L. Jones ! Steven L. Jones is an artist, writer, musician, and former instructor at Virginia Commonwealth University and the School of the Art Institute of Chicago. Kentucky-born, the son of a choir director and violinist, he lives with his wife Catherine and dog Mojo in his adopted hometown, Chicago. A longtime writer for magazines and online journals, including the Woody Guthrie Foundation magazine “Sing Out.” Murder Ballads Old & New is his first book. https://www.instagram.com/stevenljonesart/ https://sljonesart.com/home.html murder-ballads-old-new

On today's show, host Douglas Haynes speaks with Sasha Waters about her new documentary, Mary Oliver: Saved by the Beauty of the World, that premiered last week on PBS's American Masters series. The film profiles the life and legacy of one of America's greatest poets who passed away in 2019. Waters says that the film has the structure of a musical, biographical insights interspersed with poetry readings by some of Oliver's greatest fans, including Stephen Colbert and Jason Reynolds. Waters sourced readers, in part, by looking through TikTok videos of people with wild geese tattoos. The numerous readers create a dialog with Oliver's vast catalog of poetry, both well-known and new. Making a documentary about Mary Oliver was a difficult task because Oliver was very private for much of her life. But in her later life, Oliver became more outspoken, making comments about climate change and revealing her childhood sexual abuse. They also discuss Oliver's attunement to vulnerability and politics of hope.  You can view the documentary on PBS Wisconsin. Sasha Waters has produced and directed nearly two dozen documentary, experimental, and short essay films, many of which originate in 16mm. She is also a Professor of Film at Virginia Commonwealth University's School of the Arts in Richmond, Virginia. Featured image of flying geese by Enoch Leung on Flickr (CC BY-SA 2.0) Did you enjoy this story? Your funding makes great, local journalism like this possible. Donate hereThe post New Documentary Pays Tribute to Poet Mary Oliver appeared first on WORT-FM 89.9.

In late August 1619, twenty or more enslaved Africans arrived in Virginia at what's now called Fort Monroe. They were the first Africans documented in British North America. Fort Monroe's Park Superintendent Terry Brown recalls how America commemorated their arrival 407 years later. And: We hear from the Tuckers, the descendants of the very first African-American baby, about their work to uncover the stories of their ancestors. Plus: Poet Synnika Lofton reflects on 1619 and shares how he channels his political thoughts into art. Later in the show: When Ana Edwards first heard the story of Gabriel, an enslaved blacksmith who attempted a rebellion in Richmond, Virginia, she knew she needed to share it. She says new efforts to commemorate the lives and rebellions of enslaved people in the former Confederate capital are reshaping Richmond today. And: Richmond poet Joshua Poteat tells how he has been inspired by Gabriel's story. Poteat has been writer in residence at William & Mary and a visiting writer at Virginia Commonwealth University.

by Christian Medical & Dental Associations® In this episode of Faith in Healthcare, Dr. Mike Chupp and CMDA Senior Vice President Dr. Bill Griffin talk with Nathan Miller and Ethan Harris, fourth-year dental students at Virginia Commonwealth University, about building Christian community among their classmates and serving through dental missions in Rwanda and Jamaica. Their story shows what can happen when students step out in faith with the support of experienced professionals, reminding us that ministry does not begin after graduation. It begins with faithfulness wherever God has placed us today. Ethan Harris and Nathan Miller are fourth year dental students at Virginia Commonwealth University in Richmond, Virginia.  VCU previously had an active dental student group, but interest had waned in recent years.  When Ethan and Nate met during their first year they committed themselves to restarting this group, and now there's a good group of students meeting every Thursday evening. In addition to their efforts to organize the VCU Dental Student group, earlier this year Nate and Ethan accompanied Dr. Bill Griffin and other dentists on a mission trip to Rwanda, where they developed their clinical skills and also evidenced the power of the Gospel through international dental care.  In order to introduce their classmates to the profound blessing of dental mission trips, Nate and Ethan are currently preparing to lead a group of 15 VCU dental students on a mission trip to Jamaica later this Summer.

“The potential for it to save lives is huge,” said Betsy Sink, battalion chief of EMS operations for the James City County Fire Department.

Author Rachel Beanland discusses The Half Life on Book Gang—a juicy Italian-set novel exploring early marriage and finding oneself in the 1970s. I'm thrilled to welcome Rachel Beanland to Book Gang for an intimate conversation about her newest novel, The Half Life. Rachel brings her trademark honesty and warmth as she shares the personal stories and creative risks behind this lush Mediterranean tale. Together, we dive into her childhood memories, the challenges of writing from a single perspective, and the complex blend of history and self-discovery that makes this novel so unforgettable. The Half Life follows Eileen, a young newlywed,  who moves to the remote Italian island of La Maddalena in the 1970s after marrying a Navy officer. As Eileen  adjusts to the insular world of military life abroad, she finds herself navigating cultural divides, the expectations of marriage, and an unexpected awakening. Against the lush Italian landscape and under the shadow of Cold War politics, Eileen's journey becomes one of self-discovery and new identity in a place where the past and present collide. In this week's absorbing episode, we discuss:

We're taking the summer off and rebroadcasting some of our favorite episodes in the archives over the next few months. Today we're rebroadcasting our 2022 episode with Nicole Killian, who was just named Assistant Professor and Assistant Director of Graduate Studies in Graphic Design at Yale School of Art. — Nicole Killian is a graphic designer and educator whose work spans design, publishing, video, and installation. They are currently co-director of the Design, Visual Communications MFA and associate professor of graphic design at Virginia Commonwealth University. In this conversation, Jarrett and Nicole talk about studying at the Bauhaus and Cranbrook, how institutions can become more experimental, and what it means to queer design education. Links from this episode can be found at: scratchingthesurface.fm/213-nicole-killian — We're continuing to publish new content on our Substack. Paid subscribers get bonus interviews every month. Sign up and support the show here: surfacepodcast.substack.com

Unruptured intracranial aneurysms and arteriovenous malformations are frequently discovered incidentally on neuroimaging, presenting complex decisions around monitoring, referral, and treatment. This episode highlights key risk factors for rupture, the role of imaging in evaluation, and practical approaches to triage and management, including when specialist intervention is warranted. In this episode, Gordon Smith, MD, FAAN, speaks with Edgar Samaniego, MD, FAAN, authors of the article "Unruptured Intracranial Aneurysms and Arteriovenous Malformations" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Samaniego is a professor of neurology, neurosurgery, and radiology and the director of the vascular neurology fellowship at the University of Iowa in Iowa City, Iowa. Additional Resources Read the article: Unruptured Intracranial Aneurysms and Arteriovenous Malformations Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @GordonSmithMD Guest: @esamaniego Full episode transcript available here Dr Smith: Have you ever ordered an MRI of the brain and found a coincidental unruptured aneurysm or perhaps an arteriovenous malformation? If so, are you up to speed on how to manage this common situation, how to monitor, when to refer, and how to counsel your patients? If your answers to these two questions are yes and or no, then please keep listening.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Smith: This is Dr. Gordon Smith. Today, I'm interviewing Dr. Edgar Samaniego about his article on unruptured intracranial aneurysms and arteriovenous malformations. This article appears in the June two thousand twenty-six Continuum issue on cerebrovascular disease. Edgar, welcome to the podcast, and maybe you can briefly introduce yourself to our listeners.  Dr Samaniego: Yeah. Thank you, Gordon. So, I'm an interventional neurologist. I'm practicing at the University of Iowa. I've been in Iowa for the last ten years. I'm originally from Ecuador. Did my residency in Wisconsin, and then I went to Stanford for neuro critical care and stroke. And then I did my neurointerventional fellowship at the Baptist Cardiac and Vascular Institute in Miami.  Dr Smith: You're a triple threat in the world of vascular and critical care, which I want to get to later. But your article's really great. I'll admit one of the first things I do when I read an article for Continuum Audio is I see how long it is. I saw yours was as long as the rest, and I was a little surprised because this sounded like a simple topic. But having read it, it's anything but simple. This is really important and complex stuff. I wonder if maybe you can orient our listeners to the importance of this. We frequently find unruptured aneurysms or vascular malformations on brain imaging that we order for something else. I mean, how common is that, and why do you think our listeners need to be particularly attentive to our conversation today?  Dr Samaniego: It's pretty frequent that we see patients with unruptured brain aneurysms. A lot of times, you know, we do imaging like CT angiograms, or magnetic, resonance angiography. Patients come to the ER with headaches, and we find an unruptured aneurysm. And you know, the question always comes, "What should we do with this aneurysm that we found?" We know that a lot of these aneurysms will not rupture, but the caveat is that when they rupture, like fifty percent of these patients may die or have bad outcomes. So, it's always a puzzling question, you know. What should we do with the aneurysm?  Dr Smith: Well, thanks, Edgar. I mean, this is certainly something that I come across. I'm glad to hear that other people struggle with this as well. What actually is the prevalence of aneurysms in the general population? How common is this?  Dr Samaniego: It's more common than what we think, you know. The, the estimates talk about like one in every fifty people have a brain aneurysm, and about every eighteen minutes an aneurysm will rupture. In the United States, there's approximately thirty thousand ruptures per year. So, there's a significant number of, of patients affected by brain aneurysms. And, and the key thing is that affects usually younger patients who are in the most productive years of their lives. So that's why it shouldn't be ignored, and once we find an aneurysm, we have to have all the information for triaging and deciding on treatment of these aneurysms.  Dr Smith: Well, it's a great way to begin our conversation. I mean, this is not a rare problem. It's a common problem, and there's actually a really great section of the article I'll refer people to about medical malpractice and the importance of recognizing and dealing with this thoughtfully. It's an empowering section, not a scary one, but this is important for our listeners to know about. Pretty high-stakes stuff. Maybe you can orient listeners like me or maybe simple neuromuscular people. What different types of aneurysms are there?  Dr Samaniego: That's the interesting question because there's multiple types of aneurysms, and there is a whole spectrum of aneurysm. When we say aneurysm, you can be talking about a fusiform versus a saccular aneurysm. We tend to classify them based on shape, also location. But the two main classifications for brain aneurysms will be saccular, which, you know, has a sac kind of morphology shape, and then you have the fusiform aneurysms. Those are the main morphological classifications. Then on top of that, you have two other subtypes that you see quite often. The one that we see is mycotic aneurysms that is like a misnomer because it's not a fungal aneurysm. It's just an infectious aneurysm that most of the time we see on the setting of endocarditis. These behave a little bit different than the typical saccular or fusiform aneurysms. And then also you have other more rare types of aneurysms like blister aneurysms that are sometimes located in the anterior wall of the carotid artery. So, you know, within this spectrum, we have those main aneurysms. The typical aneurysms, which can be fusiform or saccular, and also the more atypical, which can be mycotic and also blister-like aneurysms.  Dr Smith: I wonder if you might comment a little bit on the relevance of the type of aneurysm, fusiform, saccular, blister, and then location on rupture risk or prognosis.You have a really great figure about anatomic classification in the article actually that I encourage everyone to check out when they hopefully read it. But what do these characteristics imply for risk?  Dr Samaniego: Yeah. This is very complex question because, you know, entails different characteristics of aneurysms such as shape, the location, morphology. So, we know that some locations, for example, the anterior communicating artery has a high risk of rupturing as opposed to patients such as the part of ophthalmic aneurysm, which are usually located at the origin of the ophthalmic artery in the internal carotid artery. So, by risk of rupturing, the highest risk is usually the anterior communicating. Then you have posterior communicating artery aneurysms, which are usually located in the internal carotid artery, but because of their proximity to the origin of the posterior communicating artery, they're called posterior communicating artery aneurysms. Then you have the posterior circulation aneurysms on top of risk of rupturing is the top of the basilar artery location. Those three are the highest risk for rupturing: ACOM, PCOM, and top of the basilar. In terms of morphology, I always tell my patients, you know, if it's like a nice-looking aneurysm that has this rounded shape is a benign morphology. If you have the aneurysm that's having these Mickey Mouse ears that has these blebs or daughter sacs, those are aneurysms that usually scare us because those are the ones that usually rupture. So that's another criteria, morphology. And then the other criteria would be size. There is this magnificent study called ISUIA, which was published several years ago, and basically what it demonstrated was that aneurysms that are seven millimeters or larger are more likely to rupture versus smaller aneurysms. So those are the three criteria that I'm looking into when talking to patients about morphology, location, size, and the, the shape or morphology of the aneurysm.  Dr Smith: So, let's say a general neurologist or comprehensive neurologist practicing in a community setting in a rural area orders a, let's just say a CT or CTA for a patient with a TIA and finds what looks like an aneurysm. What's the next step in terms of imaging? What's the best next step? I mean, there are a bunch of different imaging modalities. Do you get an MRA? Is it time-of-flight, contrasted? You know, when do you get a DSA and so forth?  Dr Samaniego: Yeah. The first thing to do is to better characterize the aneurysm. Order of more accurate imaging that we can obtain without being invasive with a diagnostic cerebral angiogram. The rest will be a magnetic resonance angiography with contrast that, you know, gives you really good detailed information about the aneurysm. Similar in terms of quality and precision will be a CT angiography. The caveat there is with CT angiography is that, you know, you use radiation, and the patient has to get iodine. And then under those two, you will have a time-of-flight magnetic resonance angiography, which doesn't use any contrast, but then you lose a little bit of quality in terms of the imaging and some morphological features you might miss. So usually what we do in my practice, I don't wanna do a diagnostic cerebral angiogram, and somebody has to refer an unruptured aneurysm. I try to do CT angiogram as a baseline, see how the aneurysm looks, and then for follow-up, I usually do magnetic resonance an- angiograms with with contrast. If there is a concern that the aneurysm has some dangerous features like it's irregular in shape, it's, it's larger, it's in one of these high-risk locations, might be better just to refer the, the patient to a specialist for a diagnostic cerebral angiography.  Dr Smith: So, you know, there are these scales that you talk about in the article. There's phases in the UIATS that are used to predict rupture risk and guide decision-making. Are these scales that general neurologists or non-vascular neurologists can use to guide care? I'm thinking of like Chad-Baskin, ASBAD, which, you know, all our residents know about. Should we all be familiar with these scores?  Dr Samaniego: I think they're very helpful in the sense that it will give us some guidance. Some of the characteristics of the scale might be up- outdated. For example, like ancestry. Although it's been described more in Japanese and Finnish populations, and North American, not as much as these two other populations. We do see a lot of aneurysms in people from North America and other backgrounds. For example, one of the biggest critiques for the phases is that doesn't take into account smoking history. Smoking that we know is a risk factor. And the other critiques for phases is that, for example, if you are older than seventy years old, you will score one point, which will increase your risk of aneurysm rupturing. Having said that, we do see like tons of aneurysms on younger patients, actually the most productive years of their lives that they rupture. So, it gives you some parameters like the presence of hypertension, the size, as I said, seven or larger, previous history of subarachnoid hemorrhage, and the location of the aneurysm. But it doesn't take into account other factors like smoking or morphological features of the aneurysm. Dr Smith: Now, you mentioned size. I'd like to maybe go back and talk about a case from your article, which I found really impactful. For our listeners, this is a sixty-four-year-old woman who had a five-millimeter ACOM aneurysm. She was imaged serially, didn't change over the time period, and then two years later ruptured with devastating consequence, right? And so that's a small aneurysm. Most aneurysms, I guess, are small aneurysms. I just wonder, when you see a patient like that, how do you handle the discussion regarding risk? And how do you decide when to refer them for an intervention?  Dr Samaniego: Yeah. It's always puzzling when we see these smaller aneurysms. And this example is a typical example of a patient that doesn't follow the rule of seven or larger aneurysm size for rupturing. We see that quite often on aneurysms located in the anterior communicating artery. Just this last week, I treated two patients with similar characteristics, with smaller aneurysms, like average size between four and five, that rupture, and both were located in the anterior communicating artery. So, we know that there is definitely a linear relationship between size and risk and rupture, but we do see a lot of patients that have smaller aneurysms, like three, four, five millimeters that rupture, and we don't really understand very well the, biology of these aneurysms. So, when we see these aneurysms, we try to maximize the characterization of the aneurysm with better imaging, try to see the morphology. And usually when an aneurysm is discovered, what we do for follow-up is a six-month follow-up with some type of imaging, CTA, MRA with contrast, and see if there's has been any change in, on the aneurysm.  Dr Smith: So, is it fair to say that a knowledgeable non-vascular neurologist can safely manage these patients, follow them over time using what they learned from reviewing your article, identify patients who have higher risk aneurysms based on the characteristics you summarize, and refer them to a tertiary center? When I get these, it's easy for me to have our vascular neurosurgeon see them or a vascular neurologist, right? But in a community where you may not have ready access to that subspecialist, is it still important to get all of these patients to a tertiary center? Are there select instances where a community-based general neurologist can follow them and then refer if there's change in size, for instance?  Dr Samaniego: Yeah. I think that everything else that we do in neurology, it's important to do some type of triage in referring some of these patients for further studying and  expert opinion. I think age and size of the aneurysm, age of the patient and size of the aneurysm are huge factors. For example, if we have an older patient in their nineties and has incidentally found two-millimeter aneurysm in a low-risk location like the parathalmic, that patient probably needs to be seen locally. I don't think merits a full workup. As opposed to a younger patient with a three-millimeter aneurysm located in the ACOM. I think that type of patient probably needs to be referred to a tertiary s-stroke center for workup. I mean, most of the time what's gonna happen is that if it's a small aneurysm with benign characteristics, you know, it's gonna be seen by the specialist and they're gonna determine some type of follow-up, which can be done locally.  Dr Smith: So maybe we can pivot a little bit and talk about AVMs, if that's okay. What's your approach to a coincidentally discovered AVM, right? I mean, presumably, we need to think about symptomatic AVMs a little differently, I would think. So maybe we can start with the same scenario we've been talking about. You get an imaging study for something else, and, well, we find an AVM. What's the approach to that situation?  Dr Samaniego: Yeah. AVMs are fascinating vascular lesions because they're very complex, they're very heterogeneous. If we're talking about the morphological features with aneurysms, this, in the case of AVMs, is way more complex in terms of location size. The complexity added to AVMs is that you have a feeding artery, you have a nidus, and then you have draining veins. So, all of these can be very heterogeneous. In case of AVMs, I think those definitely need to be referred to a tertiary center because the management of AVMs is multidisciplinary, even in the tertiary centers. You know, we don't have a magic wand that will say, you know, all these AVMs need to be treated this way. Sometimes they don't even need to be treated because we know from some studies that just watching them will be good enough.  Dr Smith: You raised management of AVMs. Maybe we can go back and talk a little bit about what's the latest in management of aneurysms. You manage aneurysms from soup to nuts and as an endovascular interventional neurologist. What's the latest in management of aneurysms?  Dr Samaniego: The latest is that, which falls within management, is that we have tools that they have not really been validated a hundred percent because we're still understanding the biology of some of these aneurysms. But high-resolution MRI will help us to define if there is some enhancement of the aneurysm. There is the thought that if there is enhancement after the administration of contrast, might be more of an inflammatory process. So that can be used for management, triage, and follow-up of some of these aneurysms. In terms of endovascular treatment, it has been really a revolution of how we treat these lesions. You know, we have a lot of new devices, better catheters to access the aneurysms.There is devices that you can place inside the aneurysm sac and it'll completely shut down flow into the aneurysm. There is other special stents called flow diverters that can take the flow away from the aneurysm and bypassing the aneurysm. So, all of these things have really revolutionized how we treat them. Having said that, you know, there's always a risk with any of these procedures, and that's why we gotta be mindful when we decide to treat these patients with unruptured incidentally found aneurysm.  Dr Smith: I've got just one more question, Edgar, which I kind of led with. You've got training as a vascular neurologist, a neurointensivist, and an interventional neurologist. And you know, Ralph Sacco, as you probably know, used to like to talk about the neurologist, and part of the neurologist was interventional. I wonder what wisdom you have to trainees that are listening to us right now who might be interested in pursuing a career as a neuroendovascular neurologist. What wisdom do you have for them about how to go about doing that?  Dr Samaniego: It has been really rewarding to be part of this process and evolution of treating a stroke and aneurysms and AVMs because I remember when I was a resident at the University of Wisconsin, we only had, like, thrombolysis and only one device for, retrieving some of these clots. But now we have, like, 10 different devices. We have two different indications or two, two different thrombolytics. So, my best advice for trainees that want to pursue neuroendovascular is to get engaged early on, understand very well the biology and the thought process because it's not only a technical field. You have to have really good judgment on when to do and when not to do the procedure, and try to find mentorship. You know, there is a lot of neurointerventional neurologists out there right now. Having a good mentor will really facilitate your career choices and getting into training.  Dr Smith: Well, Edgar, thanks so much. What an exciting conversation. It's just another great example of how exciting neurology is these days. Many exciting advances and innovations, and we just scratched the surface. I encourage all of our listeners to read the article. It's actually really, really informative. So, thank you very much.  Dr Samaniego: Thank you so much, Gordon.  Dr Smith: Again, today I've been interviewing Dr. Edgar Samaniego about his article on unruptured intracranial aneurysms and AVMs. This article appears in the June 2026 issue of Continuum on Cerebrovascular Disease. Be sure to check out other Continuum Audio episodes from this and other issues, and thanks to you, our listeners, for joining us today.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Higher ed has become an increasingly complex and challenging environment to work in. In this episode, Susan Hrach and Kitty Maynard join us to discuss the role trained coaches can play in supporting agency, resilience, and career growth for college employees. Susan is the author of Minding Bodies: How Physical Space, Sensation, and Movement Affect Learning. She's served as a Fulbright Canada Distinguished Research Chair, and recently appeared on the TEDx stage in Columbus, Georgia. Kitty is the Director of the Teaching and Scholarship Hub at the University of Richmond. Her higher ed career began as a Professor of French Studies, and she has taken on leadership roles in faculty development at Washington College and Virginia Commonwealth University before moving to the University of Richmond. She is the author of Reveries of Community: Epic in the Age of Henri IV and co-editor of Polemic and Literature Surrounding the French Wars of Religion. Susan and Kitty have both received training from, and are members of, the International Coaching Federation. They are also two of the editors of Transformative Coaching for Faculty and Staff in Higher Education. Kristin Croyle, a psychologist and the Dean of the College of Liberal Arts, Sciences, and Engineering, fills in for Rebecca in this episode. A transcript of this episode and show notes may be found at http://teaforteaching.com.

In this episode Garth interviews Jared Keeley from Virginia Commonwealth University in Richmond, VA. Jared serves as the first-year director of clinical training and talks about VCU's urban, community-serving campus and student body. He describes his dual interests in clinical psychology and the scholarship of teaching and learning, focusing on the Teacher Behavior Checklist (TBC), developed with Bill Buskist, based on interviews with award-winning teachers to create a more theory- and data-informed, formative teaching feedback tool. Jared recounts his path from Colorado to Knox College, Auburn's renowned teacher-training program, and how his work on clinician classification led to field-trial contributions to the World Health Organization's ICD. [Note. Portions of the show notes were generated by Descript AI.]

The advancement of pharmaceutical manufacturing depends heavily on the research taking place in areas such as continuous manufacturing, automation, machine learning, and AI. The maturation of these technologies will foster improved process optimization, accelerate the development of medicines, and make manufacturing more efficient and reliable. This is the second part of our conversation with Thomas Roper, PhD, co-director of pharmaceutical engineering at Virginia Commonwealth University's Center for Pharmaceutical Engineering and Sciences and graduate program director for chemical and life science engineering. Roper discusses how graduate students in his research group have helped advance technologies ranging from computational fluid dynamics and process analytical technology to machine learning applications for process optimization. He also shares why he views AI as a powerful tool, not a replacement for people, and how it's preparing the next generation of scientists and engineers.

It is rare that a constructor debuts on a Sunday, but Collin Drown, a PhD student at Virginia Commonwealth University — go Rodney the Ram! ... really, that's the VCU mascot — has pulled it off, and in fine style. The theme was quite wry, with just the right amount of punpernickel™️, and the supporting cast of clues was definitely up to the task. We have the full 411 inside, as well as a very nice bit of listener mail for your enjoyment, so, ... enjoy!Show note imagery: The North ARAL Sea, before the International Fund for Saving the Aral Sea got to workWe love feedback! Send us a text...Contact Info:We love listener mail! Drop us a line, crosswordpodcast@icloud.com.Also, we're on FaceBook, so feel free to drop by there and strike up a conversation!

The framework of modern pharmaceutical manufacturing is evolving as new technologies, advanced therapeutic modalities, and more sophisticated process control reshape how medicines are developed. While biologics, peptides, and other emerging therapies continue to expand the industry's capabilities, advances in engineering, automation, and continuous manufacturing are also transforming small molecule manufacturing. These shifts are redefining the skills, technologies, and manufacturing strategies needed to deliver high-quality medicines more efficiently and reliably. In this episode of Off Script, we spoke with Thomas Roper, PhD, co-director of pharmaceutical engineering at Virginia Commonwealth University's Center for Pharmaceutical Engineering and Sciences and graduate program director for chemical and life science engineering, about how pharma manufacturing has evolved over the course of his career and where it's headed. Roper draws on decades of experience to discuss the significance of chemical engineering in small molecule manufacturing, the growing significance of quality by control, the promise and challenges of continuous manufacturing, and how emerging catalytic technologies and automation are advancing process development. He also shares why preparing the next generation of pharmaceutical scientists and engineers will be critical as traditional boundaries between small molecules, biologics, and emerging modalities continue to disappear.

Ryan is a Professor of History at Virginia Commonwealth University. He specializes in American religious history, material culture, and historic preservation. His most recent book is Death and Rebirth in a Southern City: Richmond's Historic Cemeteries. He is also the author of "Gothic Arches, Latin Crosses: Anti-Catholicism and American Church Designs in the Nineteenth Century."​ Ryan is a founding member of the Richmond Cemetery Collaboratory and is the director of the Richmond Cemetery Project (richmondcemeteries.org). He has museum experience at the St. John's Church Foundation, the Winterthur Museum, the St. Augustine Historical Society, and the Castillo de San Marcos National Monument, among other institutions.In this conversation, Ryan and I explore a rich array of subjects, from the Shaker aesthetic to the symbolism of lighthouses in Christianity. Ryan also explains the power dynamics involved in historical Christian burial practices, and how material religion and public spaces interact to reveal important societal values and beliefs.

— In this profound and deeply heartfelt episode, Valeria sits down with Colleen Quinn to explore the sacred intersection of psychology, spirituality, breathwork, and soul awakening. Together, they dive into the transformational journey behind her upcoming book, Essence Merging — a raw and intimate exploration of trauma, healing, divine love, and the courage to return home to the authentic self. Through near-death experiences, conscious breathwork, mystical synchronicities, and emotional truth, Colleen shares how life's deepest wounds can become portals into awakening and radical self-love. Blending decades of clinical expertise with spiritual insight, this conversation invites listeners into a deeper understanding of what it means to heal not only the mind, but the soul itself. This episode is a powerful reminder that within every breakdown lies the possibility of transformation, and within every breath lives a pathway back to love. Valeria interviews Colleen Quinn — She is the author of  "Essence Merging." Colleen Quinn is a transpersonal psychologist with a child specialty along with certification in breathwork. The word psychology comes from the Greek meaning study of the soul. True healing always takes us into direct relationship with our own soul, bringing coherence to mind, body, and heart. This is Colleen's devotion, not only for herself, but for all. The most reliable way to converse with our own soul is through conscious, integrative breathwork. Colleen has taught psychology at The Ohio State University, Virginia Commonwealth University, Columbus State Community College and was the dean at Hondros College.  Colleen has published research in many top-tier scientific journals, among them Emotion, Adolescent Psychology, and Residential Treatment for Children and Youth to name a few. In her private practice, spanning decades, Colleen used Somatic Experiencing (SE) and Internal Family Systems (IFS). Both techniques use breathwork to find and feel our body's stored traumas, loving them to bring healing.  In 2018, Colleen had her second near-death experience, leading her to utter the plea, "let me be love in every moment." This was the catalyst for her spiritual awakening. Her profoundly intimate and raw transformation is chronicled in the upcoming book by Vanguard Press, Essence Merging, due out in April 2026. Colleen uses story to inspire others that there is so much more to life. Emotional truths are interwoven into an unconventional love story that connects us with Colleen and her breathwork partner as they follow the leadings of conscious breath into rediscovery of ancient tantric practices. SE and IFS come to life in her breathwork descent journeys. She weaves in pop culture, mystical synchronicities, psychology, and ancient traditions as she sheds her shame to in-spire others. This story is an invitation for readers to discover their own divine blueprint, and a guide to returning home to the sacred self.  To learn more about Colleen Quinn and her work, please visit: https://www.essencemerging.com/.

Jon is the co-founder of Pickle, as well as a Physical Therapist. He's been featured by organizations such as NYU, the University of Oxford,  WebPT,  and the United Nations, working with healthcare executives around the globe on workforce strategy and big data analytics.   Jonathon holds an MBA from the University of Oxford (UK) and a DPT from Virginia Commonwealth University. He is also a board-certified orthopedic clinical specialist, and fellow of the American Academy of Orthopedic Manual Physical Therapists.  

For decades, the Mafia was the face of organized crime in America. But while the mob's power has faded, organized crime itself has become more global, more sophisticated, and harder to track. Virginia Commonwealth University criminologist Jay Albanese has spent decades studying how criminal organizations adapt and survive. In this conversation, he explains how law enforcement weakened the traditional Mafia, how criminal enterprises shifted from controlling neighborhoods to trafficking across borders, and why he believes corruption remains one of the most important challenges facing modern societies.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

An artist and educator, C. Matthew Szösz has established a practice that revolves around experimentation and investigation of techniques and material, with a focus on understanding the ways in which physical objects and events transform into intellectual and emotional experiences. He operates and is interested in the space that exists between design, craft and fine art. Wrote William Warmus in Glass, the UrbanGlass Art Quarterly: "So each Szösz project represents a unique inquiry into outcomes driven by curiosity, inspiration, and technical opportunity. Attempting to wrestle these diverse series into unified categories is to limit the creative variation and diversity of each, to try to name the style. Perhaps it is best to list some of his most important investigations, summarize the findings, and enjoy the artifacts of Szösz's subversive and yet disciplined and meticulous process."  Since receiving his MFA(Glass) from Rhode Island School of Design, Szösz has been recognized internationally with awards such as the Irvine Borowsky Prize, the Jutta-Cuny Franz Prize, and a Tiffany Foundation Grant, and has completed numerous residencies in the US, Europe, Asia and Australia. He enjoys working as an educator, and has taught at ASP Wrøcław, Rietveld Akademie, Virginia Commonwealth University, University of Washington, University of Hawai'i, Pilchuck Glass School, Penland School of Crafts, and Bildwerk Frauenau and others, and has lectured and given numerous workshops around the world. He is the founding member of the curatorial group Hyperopia Projects and was Executive Director of Public Glass, a non-profit public access studio in San Francisco.  Szösz's work has been exhibited nationally and internationally and is represented in private collections and public institutions in the United States, Australia, Europe and Japan, including at the Corning Museum of Glass, Corning, NY, the Renwick Gallery/Smithsonian American Art Museum, Washington, DC, the Toyama City Museum of Glass, Toyama, Japan, and Het Glazenhuis, Lommel, Belgium. His career has allowed him to meet and work with friends, colleagues and collaborators across four continents and dozens of institutions. He currently lives in Seattle with his wife, Anna Mlasowsky. Recently, Szösz completed an IASPIS residency in Sweden, administered by the International Arts Grants Committee there. Later in the year, he will work at a residency in Lisbon organized by Maria Morales Lam, through her studio Lo Invisible. In the next two years, he will be visiting a pair of universities in China and teaching at Pilchuck Glass School in the summer of 2027. In between, Szösz is finishing up a commission for SeaTac airport that has been the main focus of his practice for the past three years. The project, titled Jonah, converts a part of SeaTac's north main terminal, an escalator well and a surrounding mezzanine, into a highly abstracted version of Jonah's whale. The installation has been broken into two parts -  a larger, more architectural part that creates two articulated glass walls that form the body of the whale, which was installed in December, and a more sculptural part that is scheduled for installation in September - a suspended, lighted piece that roughly corresponds to a whale's mouth holding a Pearl.  Says Szösz: "There are a number of metaphors and associations between the Jonah story and air travel, and I particularly liked the idea of the whale being a meta-space, something that has a long tradition in stained glass. I was also attracted to the apocalyptic overtones of the Jonah story in view of the current American political and environmental situation." In contrast, the personal objects and videos Szösz creates are the result of performance-based experiments documenting a deep knowledge and unbridled desire to allow the material to lead him. The artist describes his practice as "an attempt to maximize serendipity, and to allow a project to be guided by material and consequence, arriving, in the end, in an unfamiliar and unpredicted landscape. A successful project should not only be surprising but should also achieve an identity independent of the artist, and to at least some degree, escape his control and mastery." 

Is my child getting enough sleep? How much sleep does my baby need? These are common questions I get from parents, and they can create a lot of stress. The evidence I use to answer these types of questions always includes the National Sleep Foundation recommendations. So I was very excited to have Dr. Dzierzewski From the National Sleep Foundation on the podcast to talk about their latest annual poll focusing on sleep in the pediatric population, ages 0-13. I'll be honest, some of these results really surprised me while others felt very in line with what I see in my practice. our discussion focuses on the poll results, but with lots of stories, examples, and times where I share how the families I see do and do not fit into this more representative data. We talk through the role of naps, importance of bedtime routines, and the reasons many littles may not be getting enough sleep (shown by the survey results) along side the pressure for high sleep totals coming from some popular sleep apps and sites. This was a varied, data focused, and really wonderful conversation that I hope you find as fascinating as I did. About Dr. DzierzewskiDr. Joseph Dzierzewski is a nationally recognized sleep scientist, clinician, and public health leader who directs the scientific mission of the National Sleep Foundation. As Senior Vice President of Research & Scientific Affairs, he oversees the Foundation's evidence-based sleep health guidelines, shapes its research agenda, and serves as a primary scientific voice for media, industry, and policy partners across the country.A former tenured Associate Professor at Virginia Commonwealth University, Dr. Dzierzewski built a prolific research program at the intersection of sleep, aging, and behavioral medicine. He is a well-funded investigator with more than $11 million in total research support and over 400 scholarly works, including 170 peer-reviewed publications, multiple edited volumes and chapters, and more than 250 scientific presentations. Independent analyses have identified him as the most published author in the field of sleep in older adults, underscoring his leadership in this critical area of population health.Dr. Dzierzewski has served on scientific review committees for the National Institutes of Health and the American Academy of Sleep Medicine, and as Associate Editor for several academic journals. His editorial and conceptual expertise have made him a trusted arbiter of scientific rigor and a leader in shaping the direction of sleep research.A committed science communicator, he works to translate complex sleep science for the public, healthcare professionals, and policymakers. His insights have been featured across national and regional media, in podcasts, and presentations to legislative bodies. His work reflects a core belief: that advancing sleep health requires not only generating high-quality science, but ensuring that science is accessible, actionable, and impactful.Trained as a Clinical Health Psychologist with specialization in behavioral sleep medicine, Dr. Dzierzewski maintains an active clinical license, grounding his scientific leadership in real-world patient care and ensuring that his work remains connected to the lived experiences of individuals and families.Connect with The National Sleep Foundation National Sleep Foundation website: https://www.thensf.orgInstagram: https://www.instagram.com/sleepfoundation/ YouTube: https://www.youtube.com/user/NatlSleepFoundation/Resources related to this episodeSee the poll write up here: https://www.thensf.org/wp-content/uploads/2026/03/NSF-2026-Sleep-in-America-Poll-Report.pdfAnd more on the Sleep Awareness Week here: https://www.thensf.org/sleep-awareness-week/Connect with Kim Grab a free sleep myth busting guide and learn more about working with Kim: https://intuitiveparentingdc.com/Instagram: instagram.com/intuitive_parenting_dcFacebook:  facebook.com/intuitiveparentingdc

In this episode, Dr. Steve Gard, editor-in-chief of the Journal of Prosthetics and Orthotics, speaks with Cody McDonald, PhD, MPH, CPO, assistant professor in the Department of Rehabilitation Medicine at the University of Washington, and Benjamin Darter, PhD, PT, chair and an associate professor in the Department of Physical Therapy at Virginia Commonwealth University, about their JPO article, “Bone-Anchored Prosthesis Users' Experiences of Altered Lower Limb Prosthetic Attention: A Pilot Focus Group Study.” They explore how bone-anchored prostheses may reduce the cognitive effort required to use a prosthesis, a concept known as prosthetic attention. Drawing on a two-hour online focus group with four individuals who transitioned from socket-based systems to bone-anchored prostheses, the researchers identified themes of increased sensation and control, freedom from socket-related discomfort and stigma, greater awareness of fall risks and injury consequences, and the continued need to monitor terrain and component limitations. They discuss why prosthetic attention matters clinically, the surprisingly low concern about infection among participants, and the importance of helping patients understand both the benefits and ongoing challenges of bone-anchored prosthetic systems. Show notes JPO article: Bone-Anchored Prosthesis Users' Experiences of Altered Lower Limb Prosthetic Attention: A Pilot Focus Group Study O&P Research Insights is produced by Association Briefings.

Dr. Everett Worthington spent thirty years building the most rigorously tested forgiveness program in psychological science — and the day he turned in his first book on the subject was the day his mother was murdered in a home invasion. Three years later, his brother, who had discovered her body, took his own life, after Everett — a psychotherapist, a big brother — had failed to talk him into counseling. So this is not abstract research. The man giving us the REACH model, the distinction between decisional and emotional forgiveness, the six-step protocol for responsible self-forgiveness, and a vision of forgiveness scaling from heart to home to homeland is the man who has had to apply every move he teaches to the people he loved most. We spent the hour on the science, the tools, and at the end, on why the algorithmic version of America is currently training us to become exactly the kind of community in which forgiveness will not happen. Dr. Everett L. Worthington Jr. is Commonwealth Professor Emeritus in the Department of Psychology at Virginia Commonwealth University, where he taught for more than forty years before formally retiring in 2017 and remaining affiliated with the department. A licensed clinical psychologist and past president of the American Psychological Association's Society for the Psychology of Religion and Spirituality, he has published more than thirty-eight books and four hundred scholarly articles across forgiveness, humility, positive psychology, and marriage and family. His REACH forgiveness program has been validated by more than thirty randomized control trials worldwide. Explore the Science of Forgiveness — Greater Good Science Center The GGSC forgiveness hub brings together research, practices, and essays for anyone thinking seriously about forgiveness — theologically, pastorally, or personally. Join our online class – THE FUTURE OF RELIGION⁠⁠⁠⁠⁠⁠⁠⁠ Tripp and Ilia Delio are teaming up for a brand-new four-week online class, ⁠⁠⁠⁠⁠⁠⁠⁠The Future of Religion ⁠⁠⁠⁠⁠⁠⁠⁠— for everyone who's read the books, asked the questions, and realized the faith they inherited doesn't quite fit anymore. Together they'll trace religion's evolutionary arc and map what's emerging on the other side. Includes 4 video lectures, 4 live Q&As (replays available), and a community of fellow travelers. Donation-based, pay what you're able (including $0). Live sessions start this month — register at ⁠⁠⁠⁠⁠⁠⁠⁠www.thefutureofreligion.com⁠⁠⁠⁠⁠ This podcast is a ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Homebrewed Christianity ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠production. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠the Homebrewed Christianity⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Theology Nerd Throwdown⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, & ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Rise of Bonhoeffer⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ podcasts for more theological goodness for your earbuds. Join over 75,000 other people by joining our ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Substack - Process This!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Get instant access to over 50 classes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.TheologyClass.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow the podcast, drop a review⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, send ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠feedback/questions⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or become a ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠member of the HBC Community⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Learn more about your ad choices. Visit megaphone.fm/adchoices

Episode 530 / Raul De Lara(Born in Culiacán, Sinaloa, México – 1991) Raul De Lara is a sculptor who explores the emotive and storytelling qualities of materials. He is interested in how social, cultural and spiritual qualities can be imbued into wood through the act of carving. He practices traditional hand carving and power carving techniques through the visual language of nature, humor, and magical realism. His research preserves, honors and propels forward traditional uses of wood while combining them with new developments in the global industry of woodworking.  Raul  immigrated from Mexico to the United States at the age of 12, and has been a DACA recipient since 2012. His work reflects on themes of belonging, queer identity, and his im migrant experience. He is currently living and working in Queens, NY.  Raul  received his MFA in Sculpture + Extended Media from Virginia Commonwealth University in 2019, and a BFA in Studio Art from the University of Texas at Austin in 2015. Recent solo exhibition sites include The Contemporary Austin, SCAD Museum of Art and Gaa Gallery. His work has been included in exhibitions nationally and internationally at the Tucson Museum of Art, Wharton Esherick Museum, The Cheech Marin Center for Chicano Art & Culture, The Armory Show, Hermès Paris, Alexander Berggruen Gallery, The Hole, Honor Fraser Gallery, and Reynolds Gallery, among others. Raul 's selected awards include the Maxwell/Hanrahan Award in Craft, the NYSCA/NYFA Artist Fellowship in Craft/Sculpture, and Art in America Magazine's Top 20 Global New Talent, as well as residencies at Wendell Castle Workshop, Silver Art Projects, LMCC Governor's Island, the Fine Arts Work Center in Provincetown, Haystack Mountain School of Craft, Ox-Bow School of Art, Penland School of Craft, and Chicago Artists Coalition, among others.

Award-winning communication coach, corporate trainer, and financial educator Victoria Ferrer joins Tes of Revolutionary Woman to discuss confidence, public speaking, executive presence, cultural intelligence, financial education, and women in leadership. Victoria shares how personal experiences shaped her passion for helping people communicate with impact, build financial security, and lead with purpose. Maria Victoria “Vicky” Ferrer is an award-winning Corporate Trainer and Communication Coach who empowers adults and teens to rise with confidence, clarity, and cultural intelligence. With a career spanning continents, she transforms how people speak, lead, and perform by blending behavioral science, improvisation, executive presence training, and deep global insight. A four-time Distinguished Toastmaster and recipient of Toastmasters International's prestigious 2022 President's Citation Award, Vicky leads with both vision and heart. Having lived in the Middle East for more than two decades, she served as a training consultant to five American university branch campuses—Georgetown University, Texas A&M, Carnegie Mellon, Weill Cornell, and Virginia Commonwealth University—where she designed and delivered programs in leadership communication, intercultural competence, professional presence, classroom facilitation, and high-stakes presentations. Across corporate and academic environments, Vicky has trained business owners, senior leaders, managers, women professionals, and emerging talent in executive communication, persuasive storytelling, negotiation presence, crisis communication, team dynamics, emotional intelligence, stakeholder engagement, and speaking with authority under pressure. She is known for helping high performers articulate ideas with impact, navigate multicultural workplaces, influence decision-makers, and step confidently into visible leadership roles. Through powerful training, mentorship, and advocacy for lifelong learning, she champions the belief that every voice deserves to be heard and every individual has the capacity to lead with purpose. Vicky isn't just building speakers or leaders—she's building changemakers. To learn more about Victoria Ferrer: Website: https://victoriaferrerllc.com/ Instagram: https://www.instagram.com/victoriamferrer/ LinkedIn: https://www.linkedin.com/in/vmferrer/ Facebook: https://www.facebook.com/vferrerbdbamboo . . . . This episode used the following music: Time to Shine by tubebackr & Popsicles https://soundcloud.com/tubebackr https://soundcloud.com/popsiclesmusic Creative Commons — Attribution-NoDerivs 3.0 Unported — CC BY-ND 3.0 Free Download / Stream: https://www.audiolibrary.com.co/tubebackr-and-popsicles/time-to-shine Music promoted by Audio Library https://youtu.be/Cvbjhx6X4ZY

Breathing is the only bodily process that can be practiced consciously and unconsciously, tapping into the physical, spiritual and mystical all at once with a simple intake and release of the breath. Yet, like many parts of the body and self, this process has been trivialised and mechanised by the head-centric dominant culture, blocking the foundational gateway to consciousness that makes us the relational, caregivers we innately are. How can we bring the conscious back into the “unconscious” through breathwork as a crucial pathway to deprogramming the human being as separate to the rest of the world?   In this month's episode, we bring onto the show Colleen Quinn, a transpersonal psychologist with a child specialty along with certification in breathwork. Colleen has taught psychology at The Ohio State University, Virginia Commonwealth University, Columbus State Community College and has published research in many top-tier scientific journals, among them Emotion, Adolescent Psychology, and Residential Treatment for Children and Youth to name a few. In her private practice, spanning decades, Colleen used Somatic Experiencing (SE) and Internal Family Systems (IFS). Both techniques use breathwork to find and feel our body's stored traumas, loving them to bring healing.  Through a guided breathwork practice to exploring the themes of her latest book Essence Merging, Colleen takes us on a journey to remembering the human being as embodied love through the foundational pathway to consciousness - the breath. The episode is an invitation for listeners to discover their own divine blueprint, and return home to the sacred self as deeply connected to life on Earth and beyond. Visit mindfullofeverything.com to access full episode shownotes, resources and archives. Connect with us on Instagram (@mindfullofeverything_pod) and Facebook (@mindfullofeverything).

In recognition of Mental Health Awareness Month, we're proud to feature an inspiring conversation with our returning guest, Dr. Keita Franklin. Drawing from fascinating research in her latest book, The Humanity Cure: How Small Acts Can Change the World, we explore how small, intentional acts of care can make a significant impact on workplace safety and mental health. Dr. Franklin discusses how being present, showing compassion, and fostering a sense of belonging can create meaningful change across entire organizations and communities. She also highlights the critical link between mental health and safety, emphasizing how frontline leaders who demonstrate active care, along with peers who consistently support one another, help build psychologically safe workplaces where people feel valued, engaged, and committed to working safely. We also explore the transformative ripple effect of small acts of kindness and how helping others fuels a cycle of connection, resilience, and forward momentum. Don't miss this impactful episode as we take a deep dive into how small acts can make a big impact in elevating both safety and mental health. About the Guest: Dr. Keita Franklin is a nationally recognized public health leader and senior executive with more than 25 years of experience advancing large-scale systems change across federal and healthcare sectors. Her work has focused on suicide prevention, behavioral health, substance use, and the integration of public health approaches within complex organizations. A recognized expert in suicide prevention and public health leadership, she serves as Co-Director of the Columbia Lighthouse Project, where she leads national and international efforts to support the implementation and dissemination of evidence-based suicide risk screening protocols across healthcare, community, and organizational settings. Dr. Franklin holds a PhD in Social Work from Virginia Commonwealth University. For more information: https://thehumanitycure.org/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Est-ce que le fascisme a déjà eu son heure de gloire aux États-Unis ? Oui… et pas qu'un peu... Adhérez à cette chaîne pour obtenir des avantages : https://www.youtube.com/channel/UCN4TCCaX-gqBNkrUqXdgGRA/join Script: Guilhem @DHistoiresenHistoire Vignette: Charles Boidin @Boidinch 00:00 Introduction 01:28 Grande dépression 04:33 Imported fascism 12:21 Little Italy 14:44 Homegrown fascism 21:15 Hollywood 24:14 Réactions 27:30 Résistances 33:56 Conclusion Pour soutenir la chaîne, au choix: 1. Cliquez sur le bouton « Adhérer » sous la vidéo. 2. Patreon: https://www.patreon.com/hndl Musique issue du site : epidemicsound.com Images provenant de https://www.storyblocks.com Abonnez-vous à la chaine: https://www.youtube.com/c/LHistoirenousledira Les vidéos sont utilisées à des fins éducatives selon l'article 107 du Copyright Act de 1976 sur le Fair-Use. Sources et pour aller plus loin: OUVRAGES • Johann CHAPOUTOT, Christian INGRAO et Nicolas PATIN, Le Monde Nazi (1919-1945), Tallandier, 2024 • Philippe FORO, L'Italie fasciste, Armand Colin, édition de 2016 • Gavriel David ROSENFELD and Janet WARD, Fascism in America : Past and Present, Cambridge University Press, 2023 • Bernard VINCENT, Histoire des États-Unis, Flammarion, édition de 2016 ARTICLES • Chip BERLET and Stanislav VYSOTSKY, “Overview of U.S. White Supremacist groups” Journal of Political & Military Sociology vol. 34 no. 1, 2006 • Sander A. DIAMOND, “The Years of Waiting: National Socialism in the United States, 1922–1933”, American Jewish Historical Quarterly vol. 59 no. 3, 1970 • David LOBB, “Fascist Apocalypse: William Pelley and Millennial Extremism”, 4th Annual Conference of the Center for Millennial Studies, November 1999 • Fraser M. OTTANELLI, “Mussolini à East Harlem : police fasciste et identité italo-américaine”, dans l'ouvrage : Les Petites Italies dans le monde, édité par Marie-Claude BLANC-CHALEARD et al., traduit par Éric VIAL, Presses universitaires de Rennes, 2007 MEDIAS • Jim BREDEMUS, “American Bund – The Failure of American Nazism”, TRACES, consulté en mars 2026 • Dana FRANK, “You Know About the KKK, but What About the Black Legion?”, Jacobin, octobre 2024 • Jean-Pierre GRATIEN recevant Hélène HARTER, “Années 30 : quelle tentation nazie aux Etats-Unis ? | Les débats de Débatdoc”, La Chaîne Parlementaire (LCP) – Assemblée Nationale (France), 28 oct. 2024 • Arlene STEIN, “America faced domestic fascists before and buried that history”, The Conversation, 17 décembre 2025 INSTITUTIONS • “In Our Own Backyard”, California State University Northridge, University Library Digital Collections, consulté en mars 2026 • “The White Shirts: their history, founder and activity”, FBI Archives, août 1933 • “Le Bund germano-américain”, Encyclopédie Multimédia de la Shoah, United States Holocaust Memorial Museum, consulté en mars 2026 • John KNEEBONE and al., “Mapping the Second Ku Klux Klan, 1915-1940”, Virginia Commonwealth University, consulté en mars 2026 Autres références disponibles sur demande. #histoire #documentaire #usa #fascismeHébergé par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Melissa Mercado is the Tactical Manager and Practice Planner General Manager at TeamBuildr. Mercado joined TeamBuildr in 2024 first as a tactical manager before taking on additional responsibilities as the practice planner general manager in 2025. Prior to her current position, Mercado was a strength and conditioning coach at the School of Infantry-East for the Marine Combat Instructor Course and Headquarters and Support Battalion in Camp Lejeune, NC. She was in this role from 2022-2024 and spent the early part of 2022 as a strength coach at Wounded Warrior Battalion-East. Mercado began her coaching career as an intern coach at her alma mater, Radford University. She served in that role from 2017-2018 while also gaining additional experience as an intern at Virginia Commonwealth University in summer of 2018 and Clemson University the fall of 2018. From there she transitioned into the tactical field as a Fitness Specialist at Marine Corps Base Quantico, where she played a key role in the Force Fitness Instructor Course, developing the curriculum and instructing future FFI's and FFIT's. Outside of work, Mercado enjoys sunrise runs, discovering new coffee shops, lifting heavy things, walking her dog Wyatt, and cheering on the Pittsburgh Steelers and Clemson Tigers. Support the show

Although rare, recognizing NMOSD is crucial for improving patient outcomes through correct diagnostic and treatment approaches. Reports of atypical forms and increasing knowledge of clinical, imaging, and laboratory-specific features are fundamental for the accurate recognition of this condition. Research on targeted therapies and biomarkers measuring and predicting disease activity will improve NMOSD management. In this episode, Gordon Smith, MD, FAAN, speaks with Sara Mariotto, MD, PhD, coauthor of the article "Neuromyelitis Optica Spectrum Disorder" in the Continuum® April 2026 Multiple Sclerosis and Related Disorders issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Mariotto is a neurologist in the Neurology Unit in the Department of Neurosciences, Biomedicine, and Movement Sciences at the University of Verona in Verona, Italy. Additional Resources Read the article: Neuromyelitis Optica Spectrum Disorder Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @GordonSmithMD Full episode transcript available here Dr Smith: Neurology is an increasingly therapeutic specialty, and across many of our subspecialty areas, lots of new drugs are being approved. Are you interested in learning more about a historically disabling disorder for which we now have a spectrum of new therapies that, if used appropriately and promptly in the right clinical situation, promise to dramatically improve patient outcomes? If so, keep listening. My name's Dr Gordon Smith. Today I'll be talking with Dr Sara Mariotto about her article on neuromyelitis optica spectrum disorder or NMOSD, which she wrote with Dr Romain Marignier. This article appears in the April 2026 Continuum issue on multiple sclerosis.  Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Smith: This is Dr Gordon Smith. Today, I'm interviewing Dr Sara Mariotto about her article on neuromyelitis optica spectrum disorder or NMOSD, which she wrote with Dr Romain Marignier. This article appears in the April 2026 Continuum issue on multiple sclerosis. Sara, welcome to the podcast, and maybe you can start by introducing yourself to our audience.  Dr Mariotto: Yes. Thanks, Gordon. I'm Sara Mariotto. I'm a neurologist, and I work at the Neurology Unit, University of Verona, where I do both clinical diagnosis and research into neuroimmunology---so, in particular, autoimmune encephalitis, NMOSD, and MOGAD.  Dr Smith: Well, this is a super exciting area. Whenever I hear about NMOSD, I think of one specific patient I had, and I always think of her when I come across something like your article, which is really fantastic. So, before we dive into the details, I wonder if maybe you can just explain to our listeners who aren't up to speed on what NMOSD is, what the disorder is, and maybe why it's so important that all of our listeners learn how to recognize it quickly and get people started on therapy.  Dr Mariotto: Yes, sure. So, neuromyelitis optica is an inflammatory autoimmune CNS disorder usually associated with aquaporin-4 antibodies, although there are a few cases, around 10%, who can be antibody-negative. And I think it's very much important to have in mind this disease and recognize it because it can be severe, as you pointed out; can present with very severe optic neuritis, myelitis, the brain stem, or area postrema syndrome. So, it can be really severe, affect quite young people around 40 years of age---although it can affect also the pediatric population and elderly people---and, importantly, it can be treated. It's very much important to treat this patient in the acute stage very quickly with steroids or plasma exchange in addition, and then to start a chronic treatment. So, we have treatment for this condition. So, it's very much important to, to recognize it quickly and treat the patient properly.  Dr Smith: So, I wonder if we can talk a little bit about the diagnostic criteria and boundaries of NMOSD, right? So, someone who comes in with bilateral op- severe long segment optic neuritis or long segment myelitis, we think about it. But what are the boundaries? Should we be looking for this, for instance, in someone who comes in with a unilateral optic neuritis or looks like typical multiple sclerosis? Is it important to get aquaporin-4 antibodies in those patients? What do the diagnostic criteria say about this?  Dr Mariotto: So, I wouldn't test aquaporin-4 antibodies in all patients with demyelinating conditions because although aquaporin-4 antibody assay is very specific, as for all assay and all antibody testing---also for MOG antibodies, for example---some false positive results can come out. So, I would suggest to test aquaporin-4 antibodies not in typical MS cases but in those who could be suggestive for not being MS, so in all those cases with atypical optic neuritis and myelitis or other syndromes. For those cases, it's important to test aquaporin-4 antibodies, but I wouldn't test them in all typical, classical MS cases. As I said, it's quite specific, the assay, so it's uncommon to have false positive results, but it can be.  Dr Smith: Serum, CSF, both?  Dr Mariotto: So, for aquaporin-4 antibodies, they're usually present in serum. They can be positive also in the CSF. And there are a few reports of isolated CSF positivity. But if we analyze larger samples volume, then it becomes clear that isolated CSF positivity is so, so rare that it's not recommended to test them in the CSF when serum is negative. So, for aquaporin-4 antibodies, the recommended matrix of testing is serum, which is different for MOG, which is not the topic of our article but is important to mention because MOG antibodies should be tested in serum and CSF. But aquaporin-4, I would recommend to test serum.  Dr Smith: What are the boundaries between MOGAD and NMOSD? And you talked about the differential testing of antibodies, which I was going to ask about. But when should we think of NMOSD relative to MOG? Dr Mariotto: Yeah. There are aspects which are the one mentioned in the criteria, highly suggestive for NMOSD. But the clinical spectrum can be similar to that of MOGAD. Usually, although there are some clinical aspect---like, for example cortical encephalitis or ADEM, which is more typical for MOGAD, or others like area postrema syndrome, which are more typical of NMOSD. The spectrum can be similar among the two conditions, so that's why in our clinical experience, usually they ask both aquaporin-4 and MOG antibodies in patients. It's- for experts, it can be easy to differentiate the two conditions, but for nonexperts can not be so easy.  Dr Smith: Can you define area postrema syndrome? I think not all of our listeners see that every day.  Dr Mariotto: Yeah, sure. This is a syndrome which is highly suggestive of NMOSD. That's why I mention it. And it's characterized by nausea, vomiting, hiccups are known as the syndrome. And it is very, very suggestive because of the expression of aquaporin-4 in that area of NMOSD. That's why I strongly recommend for all patients who comes out to have this syndrome to test for aquaporin-4 antibodies. MOGAD is hardly ever positive for that, so I think that whenever you see a patient with that syndrome, you should think about NMOSD.  Dr Smith: I'm just curious, aquaporin-4 is a water channel, which is kind of an interesting concept. Our conversation, I really want to make sure we give clinically important information to folks, but it's so curious to me at least, how does this actually result in a inflammatory demyelinating syndrome? For a simple neuromuscular guy, what's the immunopathogenesis of this?  Dr Mariotto: Yeah, the immunopathogenesis is quite complicated, as in all CNS disorders. And of course, aquaporin-4 antibodies are the main focus, but they are not the only one. As you said, aquaporin-4 antibodies have a target, this water channel, which is at the basis of the disease, and they are produced by the interplay between T cells, B cells, and plasma cells. But then also eosinophils, macrophages, cytokines, and chemokines are involved, enter the CNS, and then another important component is complement, which is highly activated in this disease. At the end, we have astrocyte damage because astrocytes are the main target of the disease, but also axon and myelin are involved. So, it's a quite complex pathogenesis based on the antibodies, but not only on that.  Dr Smith: And this will become important when we start talking about treatment. There seems to be a recurring theme of long segment demyelination, right? Optic neuritis is typically a large percentage of the length of the optic nerve, and obviously the myelitis se- more than three segments. Do you see other long segment areas of CNS demyelination, corpus callosum or things like that? Any ideas why that is, if that's true?  Dr Mariotto: Of note, this is quite interesting because usually when we have NMOSD, we have a longitudinal involvement, especially of the optic nerve and spinal cord, while brain lesions are quite different. Like, we usually do not have the typical Dawsen fingers-like lesions that we have in MS, for example, or the classical periventricular or subcortical extensive lesions that we can see and we have in mind when we think about MS. In some cases with NMOSD, the brain is completely negative, so we do not see anything. And Dawsen lesion's quite suggestive of NMOSD. So, you're right. I mean, this is related partially to the expression of aquaporin-4, and that's why we have this typical involvement also for area postrema, for example, and maybe also our other examples of clinical aspect that we can see in these conditions. But it's basically linked with the expression of aquaporin-4, which is the main target of the disease. And that's why usually the brain doesn't show so much involvement as we can see in MS, for example.  Dr Smith: I was actually really interested in some of the unusual manifestations or phenotypes, and I don't want to get into arcadia, really, but which of these should our listeners be familiar with that would really suggest that they should be thinking about NMOSD beyond the area postrema and other features that we've already talked about that are part of the core criteria?  Dr Mariotto: Yeah. I mean, I think that the encephalic syndromes or also ADEM, which is most typical of MOGAD but can be observed also in NMOSD or PRES, for example, are syndromes that can be considered in patients with NMOSD. There are the typical ones, which are the ones showed in the criteria, but whenever we have a brainstem involvement or, like, these encephalic syndromes or also PRES, we should think about NMOSD also.  Dr Smith: Another area I was interested in are red flags. In your article, you talk about red flags that might suggest an alternative diagnosis, right? And then this presumably is particularly important in seronegative patients, which 10% is not a reasonably high number, I suppose. What are red flags we should be thinking about for some other diagnosis?  Dr Mariotto: Yeah. I would here mention two very important red flags. The first one is a very hyperacute onset. Usually these conditions, these inflammatory conditions have a subacute onset, so whenever you have a very, very acute onset, you should think about something else. This can occur sometimes also in NMOSD, but hardly ever occur. Like, a very acute myelitis, the first thing we should think about is a vascular origin, for example, with a lot of pain and not about NMOSD, although sometimes the differential diagnosis is not so easy. The second thing is a progression independently of relapses, which hardly ever occur in NMOSD. Usually in NMOSD, we have the onset, and then we have a relapsing disease course. That's why we have to treat patients always and not to stop treatment. But we do not have progression in the meanwhile, while we can have, for example, this in MS. Same thing is for MOGAD. So, these are two things that I think is very much important to keep in mind.  Dr Smith: I want to pivot to talk about treatment because that's been super exciting. But rumor has it there are new diagnostic criteria coming for NMOSD in the next year. I bet you know a bit about those. Can you give our listeners any indication about kind of where the puck is going on this? Not so much what the criteria are specifically, but what sort of diagnostic challenges are the new criteria going to help us with once they come out?  Dr Mariotto: Yeah. So basically, we are working on that, so you will read them in the next future. This is the good point of the conversation on the new criteria. And we work a lot on the definition, on the new definition and nomenclature of NMOSD; on the definition of seronegative NMOSD, which is also quite tricky; and then on the assay we should use to test aquaporin-4 antibodies, and also on potentially new syndromes which should be included into the main feature of the disease. But hopefully you will read about this very soon.  Dr Smith: Looking forward to it. And Continuum Audio listeners, you heard it here first, so thank you. Let's pivot to treatment. This has been super exciting, and I wonder if the way to approach this is to start with acute management and then sort of chronic management. Would that make sense?  Dr Mariotto: Sure.  Dr Smith: Let's say I go on service on Friday, and I have a patient who comes in with positive aquaporin-4 and bilateral optic neuritis. What's the acute approach to managing that patient?  Dr Mariotto: So, the first approach is to administer intravenous steroids, but I would not wait to escalate to plasma exchange. There is quite good evidence that we should treat the patient with additional plasma exchange very quickly, and every day of delay of plasma exchange can cause increased disability. So, we should treat patients with steroids first, and then if we are not satisfied by the recovery, soon start with a plasma exchange. There is also some evidence, although less, for IVIG, but it's important to try to treat them very quickly, even if it's Friday, you know, there is the weekend and so on. But I think it's very much important to start with steroids after excluding other infectious causes or so on, and then to start quickly with plasma exchange. The main problem could be that we do not have the results of the antibody yet.  Dr Smith: Right. So, let me ask that question. You know, let's say my patient comes in on Friday, and clinical syndrome that really looks like NMOSD, and we're waiting for the aquaporin-4. There are many places where it's hard to get plasma exchange over weekends. And so, in that setting, are you better off doing the steroids over the weekend then PLEX on Monday, or should we just give IVIG because maybe it's as good as PLEX? What's your advice there? I'm trying to get ready for Friday because I know one's coming in.  Dr Mariotto: That's true, that's true. Usually they come on Friday or Saturday. I think it's acceptable to have three days of steroids and see how the patient improves, and then after three days to start with plasma exchange. Actually, we have a very good improvement if we start between three and five days after onset. So, I think waiting for three days is acceptable just because we can see if the steroids work properly or not, and then we can quickly start to plasma exchange. But I would not wait, like, 10 days, you know, before starting with a plasma exchange, and I would not wait for antibody results.  Dr Smith: Got it. Super helpful. And I'm actually not joking around, I learned recently that I have a reputation among our residents for having lots of optic neuritis when I'm on service, which I think is sort of karmic justice for being a peripheral nerve expert. But let me ask another question. So, let's say we do that, and the patient gets three or five days of pulse methylprednisolone and five courses of PLEX, and they're not doing well. Do you then just move right along into another agent B cell depletion therapy? I mean, what's your next step in escalation in the acute setting?  Dr Mariotto: I would for sure start to, as you said, with steroids, plasma exchange, and in case IVIG, and then quickly move to chronic treatment. And for patients who are not recovering well, I would think of something which has a quick effect so we can really start treating patients very quickly. There are different options. And all over the world, there are different rules for using immunosuppression in NMOSD. Like in Italy, for example, it's different from US or other countries, Germany, for example. There are different approved treatments and different rules of using them before or after rituximab, for example. We all know that there are treatments approved for NMOSD all over the world. But in some countries, like for example in Italy, we should use rituximab first, and then if it doesn't work, escalate to the approved treatment. I know in the US it's different. But anyway, for a patient who does not improve quickly, I would start with something which has a quick effect on the disease.  Dr Smith: And then rituximab versus inebilizumab, you know, CD20, CD19, what's your advice there? Is one preferable to the other, you know, if we have options to do either?  Dr Mariotto: Yeah. So, between rituximab and inebilizumab, we know that the target, well, is different, but is anyway B cells, so CD19 and CD20. With CD19, we can affect both plasma blast, plasma cells, and B cells. That's why the target is broader. And of note, this is an approved drug, while rituximab is, in most countries, used as off-label treatment.  Dr Smith: So inebilizumab would probably be preferable if we're able to do that.  Dr Mariotto: Unfortunately, there are not so many studies comparing rituximab with the approved drug, which is, of course, a pity, but that's the case. While we have clinical trials for all the approved drugs, and although the trials were designed differently, as we mentioned in the Continuum paper, we can argue something of the comparison between the approved drugs. But it is not so clear the comparison between rituximab and the new drugs, which is also something that we should work on.  Dr Smith: And then for chronic suppressive management, what other options are there?  Dr Mariotto: So, in addition to B cells, target can be interleukin-6, as we know with tocilizumab or satralizumab, and then complement with eculizumab. These drugs are both based on the pathogenesis of the disease. That's why we also discuss it in the paper, which shows a clear involvement of complement, and among cytokines of interleukin-6. So, targeting these made clear that could improve the disease quite well, and that's why they designed some clinical trials on these drugs, which are now approved, as we said, for NMOSD.  Dr Smith: Wow, so many options, and a lot of questions, but limited time. Let me just ask a couple of more. I see a lot of myasthenia patients, and there's a lot of variability, as you know, in patients with myasthenia, the extent to which complement is an important mechanism versus other, you know, important mechanisms. To what extent is response to a complement inhibitor kind of uniform across NMOSD? Or there's some patients who just don't respond to a complement inhibitor and others that respond really well. And then just, I'll just give my second question out is, you know, what about combination therapies for patients who have particularly challenging NMOSD?  Dr Mariotto: So usually these patients have a terrific response to complement inhibitors, and this is also shown by the clinical trials where we saw how eculizumab have a very impressive effect on the disease. And also, maybe this is also your experience, a very quick effect. So that's why there are also thoughts on using it in a very acute stage of the disease. That was what I was thinking about before. But then it has a very huge effect on complement, which is a major factor involved in the pathogenesis of NMOSD also in the chronic disease stage, and that's what also we see from clinical trials. Usually, we prefer to switch treatment from one to another and not to combine them. Of course, in very difficult cases, this can be considered, but the recommendation is to switch from one of these approved drugs to the other, or from rituximab to one of the approved drugs, and try to find out the best for our patient before combining them. Dr Smith: The complement inhibitor trials are breathtaking, at least for me. If I'm trying to convince students to go into neurology, I'll say, "Take a look at that paper," because anyone who claims that we're "diagnose and adios" is so wrong. It's so exciting. So, at a high level, this must have fundamentally changed outcomes for patients. I mean, it's still a difficult disease, but what is the kind of prognosis for that patient I described who comes in, gets the therapy you talked about? What does their long-term outcome look like in this modern therapeutic environment? Dr Mariotto: So, NMOSD is almost always a relapsing disease. That's why, as we mentioned, we have to treat patients always. But the prognosis changes a lot since we were also able to use all these drugs for the disease. So, the prognosis changes if we recognize it properly and early, and if we treat NMOSD properly with immunosuppressives. So, whatever we choose it's important to start it quickly, and this is the only way that we have to improve the prognosis of this disease. We have very active cases, but we have also cases who responds quite well to this immunosuppressive treatment, since now we have, as mentioned, these ones which are very impressive and show incredible results. So, the prognosis of the disease change in the last year, thanks also to the improvement of the diagnosis and of the treatment choices for the disease.  Dr Smith: I'm just... I- maybe my last question, you know, just at a personal level, not only for you as an expert who's caring for these patients, but in the patient community, this must have been a pretty exciting period of time, right? I mean, these, these drugs are coming fast and furious, and what a change. What's the kind of zeitgeist in the community, both your professional community and amongst the patient community about where we are? Dr Mariotto: Yeah, you're right. The last years were defined the years of NMOSD and also MOGAD because we had finally approved drugs which is relevant for all the disease that we treat and changed the landscape of the disease for clinicians, but also for patients. And we have more than one, as we said, so we have more options that we can also discuss with patients to try to choose the best one in terms of activity, but also route of administration or time. Some years ago, we just had rituximab, which is not approved in most of the countries, and now we have different approved drugs. And we improved the diagnosis of the disease thanks to the availability of live cell-based assay. And then we are working a lot also on biomarkers like GFAP, for example, which has been shown to be a very attractive biomarker able to mark disease activity and maybe also prognosis on this disease. So, you're right. I mean, in the last years, the landscape of NMOSD changed a lot.  Dr Smith: Sara, thank you so much for talking with me. I could keep going for another half an hour, but I would be in trouble with my editor, so I think we probably need to wrap it up. But thank you so much. This has been very informative.  Dr Mariotto: My pleasure. Dr Smith: Mine too. Thank you. Again, today I've been interviewing Dr Sara Mariotto about her article on NMOSD, which she wrote with Dr Romain Marignier. This article appears in the April 2026 issue of Continuum on multiple sclerosis. Be sure to check out Continuum Audio episodes from this and other issues, and thanks to you, our listeners, for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Familiarity with the clinical, MRI, CSF, and serologic features of MOGAD can help neurologists recognize this condition in clinical practice. Awareness of the utility and pitfalls of the MOG antibody test is critical. The current therapeutic approach is guided by retrospective studies and the application of immunotherapies used in other autoimmune neurologic disorders. In this episode, Gordon Smith, MD, FAAN, speaks with Eoin P. Flanagan, MBBCh, coauthor of the article "Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease" in the Continuum® April 2026 Multiple Sclerosis and Related Disorders issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Flanagan is a professor of neurology and the division chair of the Division of Multiple Sclerosis and Autoimmune Neurology in the Department of Neurology at Mayo Clinic in Rochester, Minnesota. Additional Resources Read the article: Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @GordonSmithMD Full episode transcript available here Dr Smith: So, what neurological disorder can cause bilateral optic neuritis, transverse myelitis, ADEM, or can mimic acute flaccid myelitis, intracranial hypertension, viral encephalitis, or cause seizures? Sounds like the great imitator, perhaps. If you want to know and learn more about this syndrome and how you can treat it---and it is very treatable---keep listening. My name is Gordon Smith, and today I have the great opportunity to talk with Dr Eoin Flanagan from the Mayo Clinic on his article on myelin oligodendrocyte glycoprotein antibody associated disease, or MOGAD, which is in the April 2026 issue of Continuum on Multiple Sclerosis and Related Disorders.  Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: This is Dr Gordon Smith. Today I'm interviewing Dr Eoin Flanagan about his article on myelin oligodendrocyte glycoprotein associated disease, or MOGAD, which appears in the April 2026 Continuum issue on multiple sclerosis and related disorders. Eoin, welcome to the podcast, and please introduce yourself to our audience.  Dr Flanagan: Yeah, thanks so much. I'm Eoin Flanagan. I'm a neurologist at the Mayo Clinic. I'm originally from Ireland. I work in the neuroimmunology lab at the Mayo Clinic, and work and see patients with MS, MOG, and autoimmune disorders here in Rochester, Minnesota.  Dr Smith: Your article is super interesting, I think, and this has been a really rapidly evolving area over the last, you know, many years. We have many more antibodies, and MOG is something that's been around for a while, but we've certainly learned a lot more about it. This is a topic that I think will be familiar to most of our listeners, but I wonder if maybe you can just begin by laying the foundation. Like, what is MOG? What's its typical presentation?   Dr Flanagan: So, MOG is a protein on the surface of the oligodendrocyte or its CNS myelin, and it was always of interest as a potential antibody target, and initially it was investigated in multiple sclerosis. But subsequently, we recognized that the antibodies to MOG have a specific syndrome, of which about a quarter of patients are pediatric and then the remainder are adults. And they can present with a variety of syndromes, probably most commonly optic neuritis, but also acute disseminated encephalomyelitis, or ADEM. Transverse myelitis can also occur, and then some other unusual brain and brainstem cerebellar syndromes can also occur.   Dr Smith: I was really impressed in the very broad phenotypic spectrum of MOG. We'll talk more about that, of course. But I wonder if maybe you can tell us when we should be ordering MOG antibody? Given this broad variability, does anyone who has a CNS demyelinating disease need a MOG assay, only specific phenotypes? What guidance do you have for our listeners?   Dr Flanagan: Yeah. It's a great question. So, I think you have to be a little bit careful because the MOG antibody test is a little bit sticky. So sometimes we can see some low-positive false positives. So, we don't wanna order it in every single patient with classical MS. So, I suppose we'll start with who not to order it in. I think it's also a very optic nerve- and optic neuritis-central disease, so I think you really need to be considering this in a patient with optic neuritis who does not have lesions in the brain suggestive of multiple sclerosis. And then we think about some of the features: if the lesion, the enhancement along the optic nerve is long, if it's bilateral, if there's a lot of optic disc edema accompanying that, we tend to think about MOG antibodies. And then children with demyelinating disease, MOG is over-represented in that cohort, so it accounts for about a third of those. So, if you have a child with CNS demyelinating disease, particularly if they're under twelve, with ADEM presentations or other presentations, you probably want to be ordering the MOG antibody test. And then a longitudinally extensive transverse myelitis in adults, certain types of cerebral phenotypes that we can get into, you would want to consider ordering MOG antibodies too.   Dr Smith: Now, you point out in the article that it's really important that laboratories use the cell-based assay for MOG as opposed to an ELISA, for instance. Is this something folks need to be very attentive to, or are all of the commercial laboratories now using a cell-based assay?   Dr Flanagan: Yeah. I think all of the commercial labs are using cell-based assays, so we don't really get into much of an issue. There are some differences between serum and CSF, so really, serum is the optimal sample to order. There is also some differences between the live cell-based assay and the fixed cell-based assay, where the live cell-based assay may have some advantages in terms of sensitivity. And then CSF is kind of still under evaluation about its role in the condition. So in general, it's a serum test. And then we have to remember that the antibody tends to be highest at the onset, and then it goes down over time. So, if you delay your testing or you're testing a patient long after the condition, it can go negative, for example. So it tends to be highest both around the relapses and particularly at the onset of the condition.   Dr Smith: You mentioned earlier that the test is sticky, which I take to mean that there is some risk for low-titer false positives. How do you navigate that situation? When should we be suspicious about a false positive?   Dr Flanagan: Yeah. I think there's some very useful features that can help you. You know, the main differential diagnosis is going to be multiple sclerosis, particularly in the US, in regions of the northern US where MS is particularly common. So, you really wanna be making sure that if you get a positive result, low positive, that it's not multiple sclerosis. And some of the best discriminating features are CSF oligoclonal bands. They're about 85% in MS and about 15% in MOG, so an easy number to remember, 85 and 15. And then the lesions in MOG, the brain lesions, tend to disappear over time. So, if you have the advantage of that follow-up MRI a year down the line, about 70% of lesions in MOGAD will resolve, while in MS, as we know, the term means multiple scars, so the MS lesions tend to persist over time. So, they are two quite useful features that can help discriminate.   Dr Smith: And how about specific phenotypes or areas of involvement or imaging abnormalities that suggest MOG? One of the things I found really interesting in your article is there are a host of different syndromes that I think had largely been previously described, many of them, that became clear later that these were really tied to MOG antibodies. Presumably, that's helpful in interpreting the antibody assay in that patients who have, perhaps, a borderline low titer, for instance, but have a very typical phenotype are more likely to have MOG than those who have a more clearly MS-type phenotype.   Dr Flanagan: Yeah, absolutely right. Yes. So, there's certain phenotypes that we don't tend to see with MS. The acute disseminated encephalomyelitis, or ADEM, is one that's particularly common in children. And about half of people that have ADEM will be positive for the MOG antibody. So that's a syndrome you need to look out for, which would be often in children, encephalopathy, and they would have multifocal white matter lesions, sometimes involving the gray matter. A second syndrome that was an interesting discovery from a Japanese group was this unilateral cerebral cortical encephalitis, where patients can have this swelling and T2 hyperintensity, often just on one side of the brain. And it's in the cortex, and some of those patients won't have any white matter lesions. And in that situation, it's important to order the MOG antibody, and that seems to be a specific phenotype of MOGAD. But sometimes people don't think about it because the white matter is not involved. So, if you see these patients, they often present with seizures, sometimes they even have fever accompanied by it. And if you see those patients and see this radiological feature, then you really want to consider ordering the MOG antibody too.   Dr Smith: Yeah, I found that really interesting. And I- actually, my next question is perhaps a good follow-up on that, is, what are the diagnostic pitfalls? You give a lot of examples of situations and I think some cases where it's easy to get tripped up and misdiagnose someone who has MOG with another fairly common neurological problem.   Dr Flanagan: Yeah, I think some of the things that can help you when you're determining if the MOG is a true positive or false positive is the level of the antibodies. The super high titers, if it's a clear positive or very strong positive, the likelihood is that that is much more likely to be MOGAD than those low positives just above the cutoff. So that can be useful to help you discriminate from false positives. Those lesions, again, if all the lesions persist over time, that's going to be more suggestive of multiple sclerosis. Other diagnostic pitfalls, I suppose, if it's a syndrome that's not really associated with MOG, like peripheral neuropathy or other syndromes where we'll see some case reports, but usually I would be very cautious about those kind of presentations. So usually, having the antibody at a high level, and then also if they've had other symptoms suggestive of MOGAD, like if a patient has had recurrent optic neuritis and then they have an unusual brain syndrome, or they start out with an unusual brain syndrome and then have recurrent optic neuritis. You know, there are situations that make it more likely if they're having other typical phenotypes of the MOGAD where we can kind of expand the spectrum, but we have to be careful.   Dr Smith: I was really curious about the dynamic imaging findings. And you point this out both in terms of the resolution of imaging findings, but also in that patients who have an acute MOG syndrome often have very rapid evolution of the imaging abnormalities. I'm just curious, you know, why is that, and what do you make of it? Does it have a mechanistic implication, do you think?   Dr Flanagan: I don't think we know for sure. I think there's probably a lot more happening than we see on MRIs sometimes. What sometimes can happen in about 10% of patients is the initial MRI can be normal. We don't tend to see that with multiple sclerosis or NMOSD. Then what we see is it evolving over time. So, at that time, if you do a CSF, you'll often see inflammation, but we don't see the lesions. Now, that might be because the MRI is not very good at picking up cortical involvement. That can be difficult to see in MRI. Or there could be other factors. It could be a functional effect on the MOG but without frank demyelination yet, for example. Or there could be edema that you- myelin edema that you can't see as a lesion yet on MRI. But we do see that if you repeat the MRI, sometimes it'll change a lot. So, you may go from one or two lesions on the first MRI to twenty lesions on the second MRI a week later. So, it does tend to change a lot. And then over time, those lesions also resolve. So, what I say is if it's a very suspicious situation---like a child comes in with new-onset encephalitis, has inflammatory CSF---you might wanna consider repeating that MRI down the line and seeing if it's changing. And then over time, you know, a repeat MRI a year after the onset when there's brain or spinal cord lesions can be very helpful just to make sure you're on the right track, because lots of those lesions will then disappear, and that's a very clear discriminator from multiple sclerosis.   Dr Smith: Yeah, thanks. I mean, I was wondering the same thing about whether that particular feature might imply, you know, a functional abnormality as opposed to more of a structural abnormality. So probably a lot more to learn as we move forward. There are now consensus diagnostic criteria that were published a couple of years ago. I think you've already touched on kind of the general approach, but do you want to speak to those? I found your summary pretty helpful.   Dr Flanagan: Yeah, I think that those criteria are quite useful. They have three main parts to them. The first part is having a characteristic clinical syndrome. So, we talked about ADEM, we talked about cerebral cortical encephalitis, transverse myelitis that's often longitudinally extensive, and optic neuritis being the main syndromes, but sometimes other brainstem or cerebellar involvement can be seen. And then the second part is having a positive MOG antibody. And then there's some caveats there. So, if you have a high positive, then you don't really need any additional supportive criteria. On the other hand, if you're low positive, to get at those sticky antibodies that make sure it's not a false positive, you need some additional supportive clinical or MRI criteria. Or if you're only positive in CSF, you need that additional criteria. You also need to be negative for the aquaporin-4 antibody, because they can overlap clinically. And some of those supportive criteria are things that we talked about a little bit earlier, longer lesions within the optic nerve, bilateral involvement, involvement of the nerve sheath or optic disc edema. This is a situation, MOG antibody disease, where your fundoscope is useful and looking in the back of the eye and seeing swelling, because we don't tend to see that quite as often. It's less common in multiple sclerosis, but we often see prominent edema in MOGAD. And then in the spinal cord, the lesions tend to be central in the cord. Sometimes they form this H sign where it's restricted to the gray matter, and they tend to be longer, sometimes involving the conus. Patients will often have neurogenic bowel or bladder. And then in the brain, deep gray involvement, those large lesions along the cortex with swelling are some of the typical features. And then the final step is exclusion of another diagnosis. Just like with any test that we do in neurology, our final step is going to be to put that into context. So that's just a normal thing that we will always do when we get a group of test results back that we don't know what it means. We have to put it into context. So, make sure it's not multiple sclerosis, everything else does not look like multiple sclerosis, and then you can be on your way to make a diagnosis.   Dr Smith: Definitely encourage listeners to read your article. I guess I say that with every time I- or with everyone I talk to for Continuum Audio, but the images are really fantastic and the cases are fantastic. So, everything you've described is well-illustrated, including really nice schematic sort of diagrams that help differentiate NMO from MOG and MS. So, if you like MRI scans and good imaging frameworks, then this is the article for you.   Dr Flanagan: I think that's true, and the other thing is that the imaging is quite helpful because it takes a while for that antibody to come back. We're lucky at Mayo Clinic, if you work here, it, it comes back faster for you. But for many places, that time of sending it in, so a lot of times you don't know right away. So, looking at scrutinizing that MRI can be very helpful to guide you on your way and to know what you're dealing with and how to approach both the acute treatment and plans to have potentially a steroid taper after the acute treatment and those kind of things that can help guide you in that regard.   Dr Smith: Yeah. So, let's talk about treatment. You know, what's your approach to treating a patient who has an acute demyelinating syndrome related to MOG?   Dr Flanagan: So similar to other things, MOG is very steroid responsive. So, we use high-dose IV methylprednisolone in adults. That would be one gram IV for five days. And then we also will sometimes use oral steroids, twelve hundred and fifty milligrams. That's a bit of a hassle because it's twenty-five fifty-milligram tablets, it doesn't come in a larger tablet version. But it's very helpful to patients because they can get started on it right away. You don't have to set up an infusion center. So, we have used those oral steroids often in people who don't have access to an infusion center, are not in the hospital. And particularly as it's often optic neuritis, some of those patients are seen in the outpatient setting, so we can get in with treatment quickly. In patients where it's more severe, it doesn't recover quickly with steroids, then we would consider escalating to plasma exchange as our second-line treatment, and there's some retrospective data that suggests that plasma exchange can be useful. That's gonna be particularly for those people who don't have that quick response to steroids, or maybe more severe phenotypes like that brain involvement with ADEM or cerebral cortical encephalitis, where those patients might be in the hospital and quite unwell. I will say, we might get on to this, that sometimes MOG can be very, very severe and even fulminant, where there can be increased intracranial pressure, and these patients can be in the ICU, and it can be life-threatening. And so, it's really important to treat those patients aggressively, and some patients have even required hemicraniectomy or additional treatment. Sometimes IL-6 blocking medications have been used in that situation. So, monitoring and treating increased intracranial pressure in those rare patients, probably 2 or 3% that have the very severe attack, is important.   Dr Smith: I think one of the things I found interesting, and then I'd love to get your feedback on this, is that most patients with MOG seem to have a very readily treatable disorder that's monophasic, right? You treat them with steroids, and they do well. On the other extreme, there are these patients that have a much more malignant presentation, and there are some that sound like they benefit from prophylactic or some chronic therapy. What's your approach, right? In MS, we do serial scans to monitor, and obviously, our patients are on, you know, chronic disease-modifying therapy. How do you decide when you're going to provide some sort of prophylactic therapy? How do you monitor it? How long do you continue it?   Dr Flanagan: That's a great point. We don't know for sure yet, but I think for the most part, our approach has been if the patient has a single episode, they recover well from that episode. So, if that's optic neuritis, they're back to twenty/twenty vision. They have recovered well. We don't tend to use chronic maintenance immunotherapy. Sometimes after the first attack, we'll do a little bit of a slow taper, maybe over four, six weeks. We have done longer than that. And then we won't place them on any long-term treatment, because it's about 50% of patients that may have a monophasic disease, so we don't want to treat all those people who are destined never to have another relapse. On the other hand, if a patient had a very severe episode, they're in the ICU, they're intubated, some of those patients then afterwards we will start them at least temporarily on an attack prevention medication for at least a few years to get them through. Some patients will be very fearful of future relapses in that situation. Or if they don't recover well, if they're blind in one eye after an episode and then their other eye is vulnerable, or they're left with some residual deficits neurologically from a myelitis, then we would often sometimes put those patients after the first attack. But most of the time, we're gonna wait and see if they get that second attack, and then once they have the second attack, that is when we would consider a steroid-sparing medication. But I will say that there's no proven medications. We don't have any clinical trial data available yet. So some of those patients with relapsing disease, we'll either try to enroll them in a clinical trial, or we'll use an off-label treatment to try and manage their disease based on what we've learned from neuromyelitis optica or from multiple sclerosis. A few different options seem to be better, and we can maybe get into that too.   Dr Smith: Yeah, let's go there. So, what options are there? You mentioned in more fulminant disease IL-6 inhibitors, and by that I assume you mean tocilizumab, but what are the options when you want to use prophylactic therapy?   Dr Flanagan: So, that tocilizumab can be beneficial in the very acute situation, in that malignant situation. But also as an attack prevention treatment, the IL-6 blockers seem to- some of the retrospective data seems to look like it works reasonably well, so we work and see if we can get that approved. Another medication that can work well is IVIG or subcutaneous immunoglobulin as a maintenance treatment, so we would sometimes give that, like, at least one gram per kilogram once a month. The benefit of that is it doesn't lower your immune system, so there's some advantages there, particularly in people who may be more prone to infections, older people. So, we'll sometimes use that. But we do get into a lot of challenges with insurance coverage, and it can be difficult to get these approved by insurance because we only have retrospective data out there. So then for some patients, if they're in a region where there's a clinical trial available, we might try to enroll them in a clinical trial. And there are some clinical trials underway now, so hopefully in the future we'll be able to have some FDA-approved medications that can have some Class 1 data that we can follow. Because it's hard when you're just following retrospective data or anecdotal reports, it's a little bit difficult to know exactly how well you're doing with your treatments.   Dr Smith: Well, Eoin, I wonder if we could finish up by just looking into the future, right? I mean, it sounds like a fun patient population to take care of because you've got lots of great therapies and can have a durable impact. But sure would be nice to have more evidence-based therapies and an FDA approval. What trials are going on? What's the future look like?   Dr Flanagan: Yep. So, there's some trials going on in the- a couple of worldwide trials. One is on an FCRN blocker called rozanolixizumab, which is kind of like a plasma exchange-type treatment which removes your antibodies, and it's a weekly subcutaneous treatment where adults are enrolled. And the second one is called satralizumab, which is another IL-6 blocking medication. And again, that one's given once monthly under the skin. And the trial for that also includes children down to age eighteen, so for adolescents, too, that can be an option. There are trials, I believe, in Asia for tocilizumab too, and there's one starting in Australia for rituximab. So, the good news is that we're going to have some really good data down the line for lots of different agents, and we'll be able to figure out which treatments work. And this will be really of great benefit to our patients when we get that Class 1 data to kind of guide us on what we should be using and really build on the success of some of the other conditions like neuromyelitis optica spectrum disorder, where we now have four or five approved, medications that work very well.   Dr Smith: Well, Eoin, thank you. This is a great conversation. I will say that it... the topic that I was a little intimidated about. I'm a simple peripheral nerve guy, as you know. But I think moreso than any other Continuum article I've read recently, I'm, like, loaded for bear. I can't wait to go back on the inpatient service and look for some MOG patients, because your article really left me feeling kind of prepared to think through this in a clinical setting. So, thank you for the conversation, and congratulations on a really wonderful piece for Continuum.   Dr Flanagan: Yeah, thanks so much. Always a great honor to be involved in the Continuum, and thanks to all the readers out there.   Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Cancer has long been understood through a variety of biological frameworks, including genetic mutations, dysregulated signaling pathways, and uncontrolled cell proliferation. Yet, these models often capture the visible consequences of disease rather than the deeper metabolic dependencies that sustain tumor survival. Despite major advances in targeted therapies, a central challenge remains: what underlying mechanisms make cancer cells vulnerable to treatment, and how can these vulnerabilities be exploited more effectively? Increasing attention has shifted toward cellular metabolism—particularly lipid regulation and energy-sensing pathways such as AMPK—as critical determinants of tumor behavior. Scientists are now taking a closer look at how metabolism works together with stress responses like autophagy—and how this connection could be used to develop better cancer treatments. A new research paper was published in Volume 17 of Oncotarget, titled “The SCD1 inhibitor aramchol interacts with regorafenib and metformin to kill tumor cells.” The study was led by first author Michael R. Booth and corresponding author Paul Dent from Virginia Commonwealth University, in collaboration with Laurence Booth and Jane L. Roberts from Virginia Commonwealth University and John M. Kirkwood from the University of Pittsburgh Cancer Institute. Full blog - https://www.oncotarget.org/2026/04/21/scd1-inhibition-strategy-shows-potent-synergy-with-regorafenib-and-metformin-in-tumor-cell-killing/ Paper DOI - https://doi.org/10.18632/oncotarget.28861 Correspondence to - Paul Dent - paul.dent@vcuhealth.org Abstract video - https://www.youtube.com/watch?v=lmX_c2e_-HY Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28861 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, macroautophagy, ER stress, aramchol, regorafenib, BID To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Episode Description: Happy Afro-April! Ariel Johnson joins the gang w a story about runnin the gauntlet with the be-antlered big boys over in ColoradoIn their own words: I'm a 4th year PhD candidate at Virginia Commonwealth University studying how forest disturbances shape ecosystem structure, carbon cycling, and long-term ecological stability of Northern hardwood forests in Michigan. Before grad school, I worked for public lands and universities, as a biological technician, where I developed a passion for making ecological work more accessible and inclusive. I try to continue to advance both science and equity through her service with the Virginia Wilderness Committee and as a co-chair of the American Geophysical Union's Biogeosciences Early Career Committee. I'm dedicated to producing science that informs forest conservation, while helping build a more inclusive and representative environmental workforce.This episode supports: Moose SafetyHelp us keep making the show: Patreon.com/WeOutHerePodTwitter and IG @TheWeOutHerePodStart learning about whose land you're on and begin taking action https://native-land.ca/

Today, I'm giving you a “behind the reporting” podcast, where I'll provide you my personal opinion, experience and added value with information that did not make it into my recent article for the U.S. News titled: How to Start a Yoga Practice for Depression, According to Experts.In the article, I feature Dr. Ken Duckworth the Chief Medical Officer at the National Alliance of Mental Illness and author of the book, You Are Not Alone. Amy Weintraub, someone who attributes her recovery from depression in large part to yoga. While her therapist once told her that she would always struggle with mental health, Weintraub is a published author who has also trained hundreds of yoga teachers how to teach yoga for depression.  Dr. Patricia Kinser, dean of Virginia Commonwealth University's School of Nursing and Judith B. Collins and Joseph M. Teefey Distinguished Professor. She researches yoga- and mindfulness-based interventions for mental health. I will provide their expert insights alongside my sentiments for this episode of the yoga with jake podcast.Support the show

How deeply was the British Crown involved in the transatlantic slave trade? New research by historian Brooke Newman argues that, from the reign of Queen Elizabeth I, until well into the 19th century, the Crown and its navy helped expand, finance and protect the trade in enslaved African people. In this episode, Newman joins historian and broadcaster Helen Carr to examine how the monarchy's links to slavery complicate Britain's national story about abolition and its colonial past. Drawing on her new book, The Crown's Silence, she explores the evidence, considers how the subject of reparations has become caught up in the culture wars, and reflects on what a formal apology from King Charles III could mean.  Brooke Newman is an Associate Professor of history at Virginia Commonwealth University and a fellow of the Royal Historical Society. The Crown's Silence: The Hidden History of Slavery and the British Monarchy is out now.  If you'd like to become a Member and get access to all our full conversations, plus all of our Members-only content, just visit intelligencesquared.com/membership to find out more. For £4.99 per month you'll also receive: - Full-length and ad-free Intelligence Squared episodes, wherever you get your podcasts - Bonus Intelligence Squared podcasts, curated feeds and members exclusive series - 15% discount on livestreams and in-person tickets for all Intelligence Squared events  ...  Or Subscribe on Apple for £4.99: - Full-length and ad-free Intelligence Squared podcasts - Bonus Intelligence Squared podcasts, curated feeds and members exclusive series … Already a subscriber? Thank you for supporting our mission to foster honest debate and compelling conversations! Visit intelligencesquared.com to explore all your benefits including ad-free podcasts, exclusive bonus content and early access. … Subscribe to our newsletter here to hear about our latest events, discounts and much more. https://www.intelligencesquared.com/newsletter-signup/ Learn more about your ad choices. Visit podcastchoices.com/adchoices Learn more about your ad choices. Visit podcastchoices.com/adchoices

In today's episode, we sit down with Dr. Aaron Hartman to discuss his book, UnCurable: From Hopeless Diagnosis to Defying All Odds. As a board-certified physician, clinical researcher, and founder of Richmond Integrative & Functional Medicine, Dr. Hartman's path took a profound turn after adopting his daughter, Anna, who was diagnosed with severe neurological injury and cerebral palsy and labeled "incurable." Her unexpected progress challenged those assumptions and ultimately led him to embrace functional and precision medicine as a new framework for healing. Dr. Hartman was trained in conventional family medicine and earned his MD from the Medical College of Virginia. He also served as a Major in the U.S. Air Force, where he oversaw medical clinics in both the United States and Europe and received additional training in cardiology, dermatology, and nuclear and biological warfare medicine. Throughout his career, Dr. Hartman has participated in more than 70 clinical trials, published research including work in The Lancet, and cared for patients across four continents in more than 100,000 clinical encounters. He is triple board-certified, with advanced credentials in integrative, functional, metabolic, regenerative, and anti-aging medicine, and he previously served as an Assistant Clinical Professor of Family Medicine at Virginia Commonwealth University. Join the conversation to learn more about: The three pillars of healing with functional medicine. The ways that diet can heal disease. How to holistically cure conditions outside the boundaries of conventional medicine.  The intersection of gut health and brain health.  This episode offers a thoughtful look at the evolving boundaries of modern healthcare, and what it means to rethink a diagnosis once considered final. You can connect with Dr. Hartman on Instagram at @aaronhartmanmd.

Get the book, The Four Cornerstones of Effective Schools: How to Build Lasting Success Visit Darin's website, www.DrDarinThompson.com Follow Darin on Youtube @drdarinthompson Follow Darin on Instagram @drdarinthompson About The Guest Darin A. Thompson, PhD, is a veteran K-12 leader with nearly 20 years of experience and founder of Pivotal Leaders Group. A two-time outstanding principal of the year semi-finalist within his region, Dr. Thompson has led transformative school improvement efforts across multiple school divisions, resulting in double-digit gains in student outcomes and significantly closing achievement gaps for historically underserved populations. A regular presenter at conferences such as NAESP/NASSP's United Conference, Making Schools Work, and VA Alliance of Black School Educators, Dr. Thompson has contributed to Education Week, the Journal of Urban Learning, Teaching, and Research, and other publications. Dr. Thompson has become a trusted voice in educational leadership. He has delivered professional development workshops on building constructive school cultures for improvement at major conferences, including the 2024 and 2025 Virginia Alliance of Black School Educators Conference, the 2025 National Association of Secondary School Principals United Conference, and the Southern Regional Education Board's Making Schools Work Conference. Dr. Thompson's thought leadership has been featured in Education Week, including the articles “How My School Is Fighting the Surge in Chronic Absenteeism” and “How Pandemic Isolation Damaged School Culture.” He has also published in the Journal of Urban Learning, Teaching, and Research and is a contributing author of Preparing to Lead: Narratives of Aspiring School Leaders in a “Post”-COVID World. Dr. Thompson earned a bachelor of science in criminal justice and a master of public administration from Virginia Commonwealth University, and a master of education and a doctor of philosophy in educational leadership from Regent University. He is also a proud member of Kappa Alpha Psi Fraternity, Inc. To learn more about Thompson's work, follow him on LinkedIn or at @drdarinthompson on Instagram and YouTube.   This episode of Principal Center Radio is sponsored by IXL, the most widely used online learning and teaching platform for K-12. Discover the power of data-driven instruction in your school with IXL—it gives you everything you need to maximize learning, from a comprehensive curriculum to meaningful school-wide data. Visit IXL.com/center to lead your school towards data-driven excellence today.   

Hello my friends and welcome to what will prove to serve as the newest installment uploaded by your favorite disc jockey on the internet. I am a deeply devastated daddy after Virginia Commonwealth University managed to upset my TarHeels in overtime. Not to mention my love life is boring me to tears. I see comments about the potential firing of Hubert Davis and to that I say shame on you. Wash your tongue with vinegar and go dig a hole somewhere. It's Hubert Davis around here foo. I could spill into the multiple reasons for my concrete stance but I won't give you that beating right now. It's FINE. My favorite portion of this episode would either be the cold slow and throw switch on the Nas 45, Boylife in EU by Yung Lean always makes me happy and honestly I believe Eternal Sunshine by Jay Electronica might be the best rap verse ever written. That's just me. Thank you as always for being here, I hope someone out there liked it. WHAT'S GOOD WITH YOU KEISHA?? Enjoy your weekend, I bought Holes on DVD today so I'll definitely be enjoying mine. Your Host with the Most,Juan Don

This episode covers:A powerful conversation with Dr. Aaron Hartman, a physician who knows firsthand what it feels like when the medical system runs out of answers. His journey into functional medicine began when conventional care failed his adopted daughter... and what followed reshaped how he understands healing, diagnosis, and patient advocacy.Dr. Aaron Hartman, MD is a triple-board-certified physician and the founder of Richmond Integrative & Functional Medicine, where he combines traditional family medicine with functional, integrative, and regenerative approaches to help patients uncover and address the root causes of chronic illness. Inspired by his own family's complex health journey, he pursued advanced training beyond conventional medicine to better serve patients seeking comprehensive, personalized care.With more than two decades of clinical experience, Dr. Hartman has also served as an assistant clinical professor of family medicine at Virginia Commonwealth University and participated in numerous research initiatives. His work focuses on evidence-based, individualized treatment plans that integrate lifestyle, nutrition, and environmental insights to support long-term healing and optimal health.Links mentioned during this episode:Dr. Hartman's website: https://aaronhartmanmd.com/Dr. Hartman's book, Uncurable: https://amzn.to/3NxRf1LFree Initial Consultation with Dr. Megan: https://p.bttr.to/3a9lfYk Lyons' Share Instagram: www.instagram.com/thelyonsshareJoin Megan's newsletter: www.thelyonsshare.org/newsletter

In this episode of Bowel Sounds, hosts Drs. Amber Hildreth and Jason Silverman talk to Dr. Saul Karpen, the inaugural chief scientific officer for the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health at Virginia Commonwealth University, Richmond, Va., where he is a professor of internal medicine and adjunct professor in pediatric medicine at the VCU School of Medicine. We talk about new genetic discoveries in biliary atresia and the future goals of research on this important pediatric liver topic.Learning objectivesDescribe the pathophysiology of biliary atresia Understand the importance of early screening and new tools to assist in early detection Examine the newly discovered genetic etiology to biliary atresiaLinks:Guidance for the Primary Care Provider in Identifying Infants with Biliary Atresia by 2-4 Weeks of Life: Clinical ReportBilitool.orgLiver-Restricted Deletion of the Biliary Atresia Candidate Gene PKD1L1 Causes Bile Duct Dysmorphogenesis and CiliopathyStravitz-Sanyal Institute for Liver Disease and Metabolic HealthAASLDPrevious Episodes Mentioned:Bill Balistreri- Neonatal CholestasisJorge Bezerra- Advances in Biliary AtresiaDisclosures:Dr. Karpen has a non-reimbursed consulting relationship with Ipsen as BOLD PIDr. Hildreth serves as a consultant and speaker for IpsenSupport the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

From sandblasting pipe yards at 17 to advising on $10-200M M&A transactions, Dr. Greg Waller shares proven strategies for maximizing business exit value, managing buyer expectations, and why the best time to prepare for sale is 3 years before you're ready. In this episode of the DealQuest Podcast, host Corey Kupfer sits down with Dr. Greg Waller, who advises clients on complex business valuation and buy-side and sell-side M&A transactions. Greg is the managing partner of Cornerstone Valuation and a partner and managing director of Transact Capital, leading a 20-person team focused on the lower middle to middle market. Given his academic and entrepreneurial background, he jokingly refers to himself as the Blue Collar Scholar. WHAT YOU'LL LEARN: In this episode, you'll discover why professional buyers and owner-operators require completely different M&A processes, how to set realistic expectations about the gap between business value and market price, and why starting exit preparation 3 years in advance dramatically impacts final sale outcomes. Greg explains how private equity-backed platforms are blurring the traditional lines between financial and strategic buyers, what makes labor-intensive businesses particularly attractive in the current market, and the cultural complexities that emerge in international transactions. You'll also learn why the most successful exits often begin as casual conversations years before any actual sale decision. GREG'S JOURNEY: Greg's path to M&A advisory started in Youngstown, Ohio at age 17. He walked into a pipe yard with a 4-inch piece of pipe, half sandblasted and coated, half rusty. He showed the crew his before-and-after demo and landed a contract to blast the entire yard over 18 months. That first deal led to years painting elevated structural steel, bridges, water tanks, and radio transmission towers. The industry changed when EPA regulations around lead-based paint removal came in. Working on a bridge one day, a coworker with cracked hands from years of painting looked at Greg and said, "Look at my hands, look at my face. What are you doing? You're a smart boy, why don't you go back to school?" That conversation took the rest of the season to sink in, but Greg eventually left the painting business and pursued his MBA at Ohio University. Faculty members encouraged him to pursue a PhD. His initial reaction was "Are you crazy? Why would I ever want to do a PhD?" But they convinced him, and he earned his PhD in finance at Purdue University. During his 20 years in academics at Ohio University and Virginia Commonwealth University (until May 2025), Greg maintained entrepreneurial ventures including valuation work as an expert witness, real estate development, buying his father's distribution company, and building a restaurant operating group. THE BLUE COLLAR SCHOLAR: Greg's unique combination of blue-collar operations experience and academic expertise gives him a perspective most M&A advisors lack. As he puts it, "I'm as comfortable talking to the janitor as I am to a board of directors, and just being able to put yourself in those shoes and having done it really gives you a different perspective." Having been under the hood of companies across virtually every industry through ownership and valuation work, he can get into the head of sellers in ways that matter when emotions run high and expectations need managing. KEY INSIGHTS: The M&A market divides into two buyer pools requiring vastly different processes. Professional buyers (private equity and strategics) respond to structured competitive auction processes with rigorous due diligence. Owner-operators typically engage through market-making platforms where price leads the conversation. Understanding which buyer type you're targeting shapes everything about your approach. Value and price represent fundamentally different concepts. Greg uses GameStop as his example: price went through the roof despite no fundamental change to the company, then crashed. Setting realistic expectations upfront with clients about valuation ranges prevents painful surprises when market realities emerge. The critical question: "If this thing ends up pricing at the lower end of the range, are we still good to go?" The consultative approach produces the best outcomes. Greg's most successful deals were "3 or 5 years in the making" where he identified value drivers early, helped clients clean up their operations, and positioned them properly before market entry. The best time to start thinking about hitting the market is 3 years ago. Private equity-backed platforms now dominate middle-market transactions, acting like strategics by bolting on competitors but bringing institutional capital discipline. This hybrid model has made the traditional financial versus strategic buyer distinction increasingly blurry. Labor-intensive businesses with skilled workforces are commanding premium multiples as immigration policies create labor challenges. Service providers to infrastructure industries and staffing companies are particularly hot. With massive private equity dry powder and 2024's weak M&A activity, the ingredients point toward a robust 2026 market. Perfect for business owners planning exits in the next 3-5 years, entrepreneurs considering M&A advisory relationships, and anyone interested in understanding how blue-collar operations experience combined with academic expertise creates differentiated advisory value. FOR MORE ON THIS EPISODE: https://www.coreykupfer.com/blog/gregwaller FOR MORE ON GREG WALLER:https://www.linkedin.com/in/h-gregory-waller-7193bb60/https://www.facebook.com/profile.php?id=61573615328301 FOR MORE ON COREY KUPFER https://www.linkedin.com/in/coreykupfer/ https://www.coreykupfer.com/ Corey Kupfer is an expert strategist, negotiator, and dealmaker. He has more than 35 years of professional deal-making and negotiating experience. Corey is a successful entrepreneur, attorney, consultant, author, and professional speaker. He is deeply passionate about deal-driven growth. He is also the creator and host of the DealQuest Podcast. Get deal-ready with the DealQuest Podcast with Corey Kupfer, where like-minded entrepreneurs and business leaders converge, share insights and challenges, and success stories. Equip yourself with the tools, resources, and support necessary to navigate the complex yet rewarding world of dealmaking. Dive into the world of deal-driven growth today! Episode Highlights with Timestamps [00:12:39] - Introduction: Greg Waller's credentials and Blue Collar Scholar background [00:16:32] - First deal at 17: Landing the pipe yard sandblasting contract [00:20:04] - The bridge painter who told him to go back to school and career transformation [00:29:05] - How blue-collar and academic backgrounds create unique M&A advisory perspective [00:30:48] - Two buyer pools: Professional buyers versus owner-operators and their different processes [00:35:57] - Value versus price conversation and the GameStop example [00:47:05] - "The best time to start thinking about hitting the market is 3 years ago" [00:48:21] - Why the line between financial and strategic buyers is increasingly blurry [00:50:15] - International deal complexities and cultural differences [00:54:19] - Market outlook for 2026: Labor challenges driving premium multiples [00:57:40] - What freedom means: Clean conscience and ability to chart your own destiny Guest Bio Dr. Greg Waller advises clients on complex business valuation and buy-side and sell-side M&A transactions. He is the managing partner of Cornerstone Valuation and a partner and managing director of Transact Capital, leading a 20-person team focused on the lower middle to middle market ($10-200M enterprise value range). His key industry verticals include human resource companies, staffing, industrials and infrastructure, healthcare, technology, and consumer products. Greg holds a PhD in finance from Purdue University and, until May 2025, was a tenured professor at Virginia Commonwealth University, where he taught courses and published research on corporate finance, mergers and acquisitions, and corporate governance. He previously taught at Ohio University. Greg is the son of a blue-collar entrepreneur and owned and operated an industrial painting company specializing in elevated structural steel infrastructure before pursuing his academic career. He has also been a partner in a real estate development firm and restaurant operating group, and now owns his family's industrial painting equipment distribution company. Given his academic and entrepreneurial background, he jokingly refers to himself as the Blue Collar Scholar. Host Bio Corey Kupfer is an expert strategist, negotiator, and dealmaker with more than 35 years of professional deal-making and negotiating experience. Corey is a successful entrepreneur, attorney, consultant, author, and professional speaker deeply passionate about deal-driven growth. He is the creator and host of the DealQuest Podcast. Show Description Do you want your business to grow faster? The DealQuest Podcast with Corey Kupfer reveals how successful entrepreneurs and business leaders use strategic deals to accelerate growth. From large mergers and acquisitions to capital raising, joint ventures, strategic alliances, real estate deals, and more, this show discusses the full spectrum of deal-driven growth strategies. Get the confidence to pursue deals that will help your company scale faster. Related Episodes Episode 350 - Tom Dillon: Understanding Business Valuation and Exit Planning Realities Episode 325 - Kelly Finnell: Using ESOPs in Ownership Succession Planning Episode 330 - Pete Mohr: Building Enterprise Value and Exit Readiness Episode 339 - Solocast 74: Equitizing Key Employees and Succession Planning Strategies Follow DealQuest Podcast: LinkedIn: https://www.linkedin.com/in/coreykupfer/ Website: https://www.coreykupfer.com/ Follow Greg Waller:https://www.linkedin.com/in/h-gregory-waller-7193bb60/https://www.facebook.com/profile.php?id=61573615328301 Keywords/TagsM&A advisory, business valuation, exit planning, sell-side advisory, lower middle market, professional buyers, strategic buyers, private equity, business sale preparation, enterprise value, Blue Collar Scholar, deal structuring, owner-operators, business exit strategy, middle market M&A, exit readiness, business succession planning, international M&A, cross-border transactions, 2026 market outlook

Today's episode is a deep dive into tactile defensiveness and sensory distress, especially around clothing. My guest is Kathryn Hamlin-Pacheco, an occupational therapist who helps kids and families understand their brains and bodies through everyday neuroscience. Kathryn will break down what's actually happening in the brain and nervous system when children experience tactile defensiveness, and why clothing can feel so overwhelming for some kids. We talk about the role of co-regulation, how parents can help create positive associations with getting dressed, and practical strategies for supporting children in navigating their sensory experiences with more safety and less stress. This episode is a grounding, compassionate look at sensory processing—and a reminder that when we understand what's underneath the behavior, everything shifts. About Kathryn Hamlin-Pacheco Kathryn (Katie) Hamlin-Pacheco, M.S., OTR/L, ASDCS, is an occupational therapist, former teacher, author, and founder of the Brain Executive Program. Kathryn is an Autism Spectrum Disorder Clinical Specialist (ASDCS) and holds certifications in Neuroscience for Mental Health Professionals and in Brain Structure and Function: Application to Sensory Integration and Processing. She graduated from Virginia Commonwealth University with a Master's degree in Occupational Therapy, where she also worked with the Virginia Leadership Education in Neurodevelopmental Disabilities program to pursue her desire to be an advocate and leader in pediatric healthcare. She has shared her work at AOTA's Inspire Conference (the world's largest gathering of occupational therapy practitioners!), Sensory Integration Education's international conference, and at William & Mary's Center for Gifted Education. In addition, Katie has written for OT Practice Magazine, Autism Parenting Magazine, Washington Family Magazine, and Stars & Stripes Magazine. Her book, How to Be a Brain Executive: And Get Sensory Sharp!, was a top Amazon release in two categories. Things you'll learn from this episode  How tactile defensiveness reflects a nervous system response rather than behavioral resistance Why understanding sensory processing is essential for supporting children with clothing challenges How co-regulation helps children feel safe, connected, and more able to tolerate sensory input Why play and low-pressure practice can make clothing experiences more manageable How creating calm environments and positive associations supports sensory integration over time Why sensory health is a vital part of children's overall well-being Resources mentioned Brain Executive Program (Kathryn Hamlin-Pacheco's website) Kathryn's online Sensory Dressing Course How to Be a Brain Executive: And Get Sensory Sharp! by Kathryn Hamlin-Pacheco Brain Executive Program on Instagram Brain Executive Program on Facebook Deb Dana on Befriending Our Nervous System Using Polyvagal Theory (Tilt Parenting podcast) Dr. Stephen Porges & Karen Onderko on the Safe and Sound Protocol (Tilt Parenting podcast) Dr. Mona Delahooke on the Power of Brain-Body Parenting (Tilt Parenting podcast) Brain-Body Parenting: How to Stop Managing Behavior and Start Raising Joyful, Resilient Kids by Dr. Mona Delahooke Sensory Processing Differences with Carol Kranowitz (Tilt Parenting podcast) The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Differences by Carol Kranowitz Polyvagal Card Deck: 58 Practices for Calm & Change Polyvagal Practices: Anchoring the Self in Safety by Deb Dana Debbie's TedxBerlin talk: What if Feeling Broken Wasn't the End of the Story? Learn more about your ad choices. Visit podcastchoices.com/adchoices

Episode 513 / Langdon GravesLangdon Graves is a Virginia-born, New York City-based artist who holds a BFA from Virginia Commonwealth University in Painting & Printmaking and an MFA from Parsons School of Design. She is adjunct faculty at Parsons and Assistant Professor in the Graduate Fine Arts program at Pratt Institute. Langdon has shown her work throughout the United States, Canada, Europe and Australia with solo and group exhibitions that include Dinner Gallery, TEI's Art in Buildings, Mrs., Tilton Gallery, Deanna Evans Projects, Grimm, Taymour Grahne Projects, STONELEAF and the Delaware Contemporary Museum. Langdon has attended the Fountainhead Residency in Miami, the Kunstenaarsinitiatief Residency and Exhibition Program in the Netherlands, the Object Limited residency in Bisbee, Arizona and STONELEAF Retreat in upstate New York. She is a recipient of Canson & Beautiful Decay's Wet Paint Grant and has been featured in Artnet, Art in America, Hyperallergic, Vice Creators Project, Juxtapoz, Art F City, The Wall Street Journal, the Artmatters podcast and Madeline Schwartzman's See Yourself X.

#683: Candy now — or a toy later? You slide play money across the table and let your kid choose. That moment kicks off this episode, where Dr. Stephen Day joins us to talk about building a “mini economy” at home.  Dr. Day is the director of the Center for Economic Education at Virginia Commonwealth University. He also holds a PhD in social studies and economics curriculum and instruction. His work looks at how kids form money habits long before they deal with real paychecks, budgets, or credit cards. We break down how a mini economy actually works. Kids have job titles tied to age-appropriate chores. They earn play money. They spend it at a small household store set up on the kitchen table. The store might sell candy, small toys, or privileges like extra screen time. Parents set the prices. Kids decide whether to spend right away or save for something bigger. You hear how this plays out inside Day's own house. A three-year-old takes on the role of “zookeeper,” feeding the cat and picking up stuffed animals. A seven-year-old creates a weekly plan that alternates spending and saving, using patterns she learns at school. A five-year-old chooses to donate part of his earnings instead of spending anything. The system stays the same. The choices vary by kid. The conversation moves through childhood stage by stage. Early years center on routine, structure, and basic trade-offs. Elementary school becomes the key period for practice, when habits and norms take shape. Middle and high school bring longer planning timelines, more independence, and deeper conversations about work, contribution, and goals. We also dig into questions parents ask all the time. Should kids get paid for chores, or should chores come with living in the house? Day explains how families can separate family work, paid jobs, and service work so kids understand why they are doing each task. Clear categories help avoid confusion about motivation and responsibility. Busy schedules come up, too. Sports practices, travel, school events, and late workdays often knock chore systems off track. Day explains how vague expectations create conflict and why job titles and defined duties bring structure even during chaotic weeks. Throughout the episode, the focus stays on practice, not lectures. Kids do not learn money by hearing explanations. They learn by earning, choosing, saving, spending, and living with trade-offs — all inside a system small enough to fit on a kitchen table. Resource: EconEdLink, a CEE program https://econedlink.org Timestamps: Note: Timestamps will vary on individual listening devices based on dynamic advertising run times. The provided timestamps are approximate and may be several minutes off due to changing ad lengths. (00:00) Intro (02:00) Teaching kids money (03:59) Mini economy basics (06:20) Money skills by stages (10:41) Starting at age three (12:02) Cat job example (16:08) Goods versus privileges (17:27) Bugging versus choices (18:11) Paying for chores (20:22) Family job service (24:56) Busy weeks and chores (33:21) Low-consumption kid example (39:17) Shared jobs and teamwork (43:34) Exchange rate to dollars (1:00:28) Investing, 529, compound interest Learn more about your ad choices. Visit podcastchoices.com/adchoices